Metacarpophalangeal dislocation (finger): Difference between revisions
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**Joint appears hyperextended to 60-90 deg | **Joint appears hyperextended to 60-90 deg | ||
*Complex: dislocation | *Complex: dislocation | ||
**MCP joint is in moderate hyperextension | **MCP joint is in moderate hyperextension with metacarpal head prominent in palm | ||
**Volar plate is interposed in MCP joint space | **Volar plate is interposed in MCP joint space | ||
**X-ray may show seasamoid within joint space (pathognomonic) | **X-ray may show seasamoid within joint space (pathognomonic) | ||
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*Apply pressure over dorsum of proximal phalanx in distal and volar direction | *Apply pressure over dorsum of proximal phalanx in distal and volar direction | ||
===[[Splinting]]=== | ===[[Splinting]]=== | ||
*Splint | *Splint with MCP joint in flexion | ||
*Refer to hand surgeon | *Refer to hand surgeon | ||
Revision as of 23:44, 11 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
Diagnosis
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