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J Am Acad Orthop Surg, Vol 17, No 5, May 2009, 318-324.
© 2009 the American Academy of Orthopaedic Surgeons
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Metacarpophalangeal Joint Dislocation

Paul Dinh, MD, Adam Franklin, MD, Brian Hutchinson, MD, Stephen B. Schnall, MD and Isabella Fassola, MD

Dr. Dinh is Hand Fellow, Department of Orthopaedic Surgery, Keck School of Medicine, LAC/USC Medical Center, Los Angeles, CA. Dr. Franklin is Resident, Department of Orthopaedic Surgery, Keck School of Medicine, LAC/USC Medical Center. Dr. Hutchinson is Hand Fellow, Department of Orthopaedic Surgery, Keck School of Medicine, LAC/USC Medical Center. Dr. Schnall is Professor, Clinical Orthopaedics and Surgery, Department of Orthopaedic Surgery, Keck School of Medicine, LAC/USC Medical Center. Dr. Fassola is Faculty Member, Department of Orthopaedic Surgery, Keck School of Medicine, LAC/USC Medical Center.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Dinh, Dr. Franklin, Dr. Hutchinson, Dr. Schnall, and Dr. Fassola.

Reprint requests: Dr. Schnall, Keck School of Medicine, University of Southern California, 2025 Zonal Avenue, GNH 3900, 9312, Los Angeles, CA 90089.

Traumatic dislocation of the metacarpophalangeal joint is a relatively uncommon injury. The dislocation may be easily reducible (ie, simple) or require surgical intervention (ie, complex). The flexor tendons, lumbrical muscle, natatory ligament, and superficial transverse metacarpal ligament combine with the displaced volar plate to create a tight noose, preventing reduction. Surgical approach may be dorsal or volar; however, the radial digital nerve to the index finger is especially at risk through the volar approach. Reported complications include stiffness, arthritis, osteonecrosis of the metacarpal head, and even premature closure of the physis.






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Copyright © 2009 by the American Academy of Orthopaedic Surgeons.