Metacarpophalangeal dislocation (finger): Difference between revisions
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Revision as of 10:41, 22 July 2016
Background
- Usually due to hyperextension forces that rupture volar plate causing dorsal dislocation
Clinical Features
Differential Diagnosis
Hand and finger dislocations
- Finger dislocations
- Thumb dislocations
- Hand dislocations
Evaluation
Types
- Simple: subluxation
- Joint appears hyperextended to 60-90 deg
- Complex: dislocation
- MCP joint is in moderate hyperextension with metacarpal head prominent in palm
- Volar plate is interposed in MCP joint space
- X-ray may show seasamoid within joint space (pathognomonic)
- Closed reduction is not possible
Management
Reduction
- Do NOT hyperextend joint (may convert subluxation into complete dislocation)
- Flex the wrist to relax the flexor tendon
- Apply pressure over dorsum of proximal phalanx in distal and volar direction
Splinting
- Splint with MCP joint in flexion
- Refer to hand surgeon
Disposition
- Outpatient managment