Abstract

We describe the presentation of a patient with sudden, sharp pain associated with a snapping sensation, swelling and pain over the metacarpophalangeal joint (MCPJ) with no history of direct trauma. The finger was held in 30 degrees of flexion and significantly deviated to the ulnar side with loss of extension. A diagnosis of traumatic rupture of the radial sagittal band of the extensor mechanism was made but the cause at exploration was found to be impingement of an osteochondral fracture fragment. This is a rare cause of irreducible loose body ‘locking’ of the metacarpophalangeal joint.

Highlights

  • A 72 year old, right-handed female rheumatoid arthritis patient was referred to our department with an acutely painful, swollen left middle finger

  • We describe the presentation of a patient with sudden, sharp pain associated with a snapping sensation, swelling and pain over the metacarpophalangeal joint (MCPJ) with no history of direct trauma

  • A diagnosis of traumatic rupture of the radial sagittal band of the extensor mechanism was made but the cause at exploration was found to be impingement of an osteochondral fracture fragment

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Summary

Introduction

We describe the presentation of a patient with sudden, sharp pain associated with a snapping sensation, swelling and pain over the metacarpophalangeal joint (MCPJ) with no history of direct trauma. The finger was held in 30 degrees of flexion and significantly deviated to the ulnar side with loss of extension. A diagnosis of traumatic rupture of the radial sagittal band of the extensor mechanism was made but the cause at exploration was found to be impingement of an osteochondral fracture fragment.

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