Metacarpophalangeal dislocation (finger): Difference between revisions
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==Background== | ==Background== | ||
*Usually due to hyperextension forces that rupture volar plate causing dorsal dislocation | |||
==Clinical Features== | ==Clinical Features== | ||
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==Diagnosis== | ==Diagnosis== | ||
===Types=== | |||
*Simple: subluxation | |||
**Joint appears hyperextended to 60-90 deg | |||
*Complex: dislocation | |||
**MCP joint is in moderate hyperextension w/ 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== | ==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 w/ MCP joint in flexion | |||
*Refer to hand surgeon | |||
==Disposition== | ==Disposition== | ||
Revision as of 07:25, 1 June 2015
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 w/ 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 w/ MCP joint in flexion
- Refer to hand surgeon