A Rare Presentation of Palmar Metacarpophalangeal Dislocation of the Long Fingers: A Case Report and Review of the Literature

Abstract

Background: Metacarpophalangeal dislocation is a rare condition in traumatology, and its management remains unclear due to the limited number of reported cases and studies. This study aims to compare our approach and outcomes with those reported in the literature, to gain a better understanding of the variability in management and outcomes across different cases and settings. Case report: Here, we present the case of a 32-year-old male patient who sustained palmar metacarpophalangeal dislocation following a traffic accident. The diagnosis was confirmed through hand X-ray, and we successfully performed reduction under locoregional anesthesia using external maneuvers. Early rehabilitation was initiated, and the patient had a satisfactory 6-month follow-up result, with full recovery of joint amplitudes and comparable pinch strength. Discussion: It appears that several mechanisms can lead to this condition, and diagnosis is typically made through radiography or MRI. Closed reduction by external maneuvers is often successful, but surgery may be necessary in cases of irreducibility or instability. Different surgical approaches may be used depending on the specific type of dislocation, with the dorsal approach being preferred for hyperflexion dislocations and the palmar approach being preferred for hyperextension dislocations or cases with an unknown mechanism. Conclusion: More research is needed to better understand this rare condition and its optimal management.