Four open metacarpophalangeal joint dislocations

Abstract

Metacarpophalangeal joint dislocation was first described in the literature by Farabeuf[5] in 1876, and until 1957, developments in the mechanism, treatment, and follow-up of closed and open MCP joint dislocation have remained stable. Kaplan[6] identified four constricting factors surrounding the metacarpal head, which cause its buttonholing into the palm, that gained popularity this year, and defined it under two subtitles as simple and complex. When the literature was reviewed, the order of frequency was determined as the fifth, second, third, and fourth MCP joints, provided they are closed dislocations.[7,8] Multiple dislocations of the metacarpophalangeal (MCP) joint are uncommon, and those that are open are always complex and need a surgical intervention for reduction. Metacarpophalangeal joint dislocations are often closed. Cases of open dislocations at the volar side of the hand that presents with skin tearing are exceedingly rare and are of a complex type. These should be urgently reduced following surgical debridement, and surgical reconstruction should be performed if necessary. In this report, we describe a 55-year-old male right-hand dominant mason that presented with open volar dislocations of the second, third, fourth, and fifth MCP joints after a fall on his outstretched hand. In conclusion, high-energy blunt trauma to the MCP joint can seriously affect hand functions when appropriate treatment is delayed, and therefore, it is an accepted principle that definitive reconstruction should be done as quickly as possible to obtain optimal functional results.