Simultaneous Complex Open Dorsal Dislocation of Four Metacarpophalangeal Joints

Abstract

Introduction: Metacarpophalangeal (MCP) joints dislocations are rare, especially the simultaneous complex dislocations of four MCP joints. Although there are over 100 reported cases of MCP joint dislocation, the vast majority involves the index finger and is extremely rare in the long or ring fingers. Up to present, only three cases of simultaneous complex dorsal dislocation of four joints were described in the literature. Case Presentation: We present a rare case of complex dorsal dislocation of four MCP joints. Physical examination and radiographic evaluation revealed open dorsal MCP joint dislocation of index, middle, ring and little fingers. Any attempt of closed reduction was unsuccessful, before surgery. The patient in the case underwent open reduction and, after surgery, the injured hand was placed in a short extension block splint and controlled active motion, while in splint, was encouraged, immediately. This approach resulted in an uneventful recovery. Conclusions: We described the complex dorsal MCP joint dislocation of four joints, which is defined as irreducible and complete dislocation, most often because of volar plate interposition. Although the dorsal and volar approaches are common methods of treatment, in complex MCP joint dislocations, however, to our knowledge, the dorsal approach has better advantages, compared with the volar type.