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Open metacarpophalangeal dislocations: literature review and case report

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HAND

Abstract

Background

Open dorsal metacarpophalangeal joint dislocations are rare. We report the case of a 62-year-old man who fell from a height of 10 m onto his left outstretched hand and presented to us with four open dorsal metacarpophalangeal joint dislocations. We review the literature and present our case to elucidate the best treatment protocol for open dorsal metacarpophalangeal joint dislocations.

Methods

A systematic review was conducted using MEDLINE, Embase, and PubMed from 1946 to present. Publications were found using key terms and cross-referencing. Detail on patient demographic, presentation, mechanism of injury, injury management, and outcome were collected.

Results

A total of 102 articles of metacarpophalangeal joint dislocation (excluding thumb dislocations) were identified. Of these, only four were of open dorsal metacarpophalangeal joint dislocation involving the four long fingers. Open dislocation of the metacarpophalangeal joint in these studies showed no hand predominance, nor association with hand dominance.

Conclusion

Open dorsal metacarpophalangeal joint dislocations of the four long fingers are unusual. Based on the available case reports and our experience, we suggest addressing this injury intraoperatively with minimal delay. Most cases will be associated with volar plate injury, and we encourage its repair with figure-of-eight stitches. Postoperatively, we suggest a dorsal blocking splint for 2 weeks followed by occupational therapy consisting of passive and active range of motion (ROM) exercises and adjunctive therapies to control edema and optimize scar tissue. Inadequate management of such injuries could be highly detrimental to hand function.

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Conflict of Interest

Julian Diaz Abele declares that he has no conflict of interest.

Stephanie Thibaudeau declares that she has no conflict of interest.

Mario Luc declares that he has no conflict of interest.

Statement of Human and Animal Rights

Procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

Statement of Informed Consent

Written patient consent was obtained for publication of the surgical procedure, management, photographs, and video clip.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada

    J. Diaz Abele, S. Thibaudeau & M. Luc

Authors
  1. J. Diaz Abele
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  2. S. Thibaudeau
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  3. M. Luc
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Corresponding author

Correspondence to J. Diaz Abele.

Additional information

J. Diaz Abele and S. Thibaudeau are first co-authors.

Electronic supplementary material

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AP view of hand active flexion and extension after surgery (MP4 9166 kb)

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Diaz Abele, J., Thibaudeau, S. & Luc, M. Open metacarpophalangeal dislocations: literature review and case report. HAND 10, 333–337 (2015). https://doi.org/10.1007/s11552-014-9646-6

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  • DOI: https://doi.org/10.1007/s11552-014-9646-6

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