J Korean Orthop Assoc.  1975 Mar;10(1):111-116. 10.4055/jkoa.1975.10.1.111.

Dislocations of the Metacarpophalangeal Joints of the Fingers: Report of 2 Cases

• Kim NH
• Oh HY

• KMID: 2471454
• DOI: http://doi.org/10.4055/jkoa.1975.10.1.111

Abstract

Dislocation of the metacarpophalangeal joint of the finger is apparently rare except in the thumb. Closed reduction of this peculiar dislocation is usually unsuccessful. In 1957. Kaplan made a thorough study of dislocations of the metacarpophalangeal joint of the index finger and emphasized that open redaction is usually necessary. He advocated a triple incision, that is release of the anterior fibrocartilaginous plate, the natatory ligament, and the superficial transverse metacarpal ligament, exposing the joint through a palmar approach. In the index finger, the dislocated metacarpal head becomes firmly wedged between the fibrocartilaginous plate and the superficial transverse metacarpal ligament. The flexor tendon traps the matuurpal head from the ulnar side and the lumbrical does so radially. Because of the more radial course of the long flexor tendons, in the little finger the flexor tendons trap the metacarpal heal on the radial side while the tendon of the abductor digiti minimi is the ulnar trapping element. We experienced a case of dislocation of the metacarpophalangeal joint of the index finger and a case involving the little finger which presented an essentially similar problem. As advocated by Kaplan, a triple release was carried out with satisfactory results. We report these rare and interesting cases with a review of literature.

MeSH Terms

Dislocations*
Fingers*
Head
Joints
Ligaments
Metacarpophalangeal Joint*
Tendons
Thumb

Figure

• 

• 

• 

• 

• 

• 

• 

Reference

1.Baldwin L.W.., Miller D. L.., Lockhart L.D.., Evans E. B.Metacarpophalangeal joint dislocation of the fingers. J. Bone & Joint Surg., 4. 9-A:1587. 1967.

2.Barnard H.L.Dorsal dislocation of the first phalanx of the little finger: Reduction by Farabeuf's dorsal incision. Lancet. 1:88. 1901.

3.Burman M.Irreducible hyperextension dislocation of the metacarpophalangeal joint of a finger. Bull. Hosp. Joint Dis. 14:290. 1953.

4.Hunt J. C.., Watta H. B.., Glassgow J.D.Dorsal dislocation of the metacarpophalangel joint of the index finger with particular reference to open dislocation. J. J. Bone & Joint Surg. 49-A:1572. 1967.

5.Kaplan E. B.Dorsal dislocation of the meacarpophalaiigeal joint of the index finger. J. Bone & Joint Surg. 39-A:1081. 1957.

6.Kaplan E. B.Functional and surgical anatomy of the hand. p. 39–44. 144-147.Philadelphia, J. B. Lippincott Co.;1953.

7.Lipscomb P.R.., Janes J. M.Twenty-year follow-up an unreduced dislocation of the first metacarpophalangeal joint in a child. J. J. Bone & Joint Surg. 51-A:1216. 1969.

8.Milch H.Subluxation of the index metacarpophalangeal joint. j. Bone & Joint Surg. 47-A:522. 1965.

9.Milford L.Campbell's operative orthopaedics. Ed. 5. l:p. 185. Saint Louis: C.V. Mosby Co.;1971.

10.Murphy A.F.., Stark H. H.Closed dislocation of the metacarpophalangeal joint of the index finger. J. Bnne & Joint Surg. 49-A:1579. 1967.

11.Ridge E. M.Dorsal dislocation of the first phalanx of the little finger. Lancet. 1:781. 1901.

12.von Raff 1er W.Irreducible dislocation of the metacarpophalangeal joint of the finger. Clin. Orthop. 35:171. 1964.

13.Watson-Jones R.Fractures and Joint Injuries. Ed. 4. 2:p. 640. Baltimore: Williams and Wilkins Co.;1960.