No abstract available.
Metacarpophalangeal Joint* ; Palmar Plate*

Traumatic dislocation of the metacarphophalangeal joint is a rare injury. Complex dislocation often require surgical procedure due to its anatomical characteristics. We report one case of surgically treated traumatic dislocation of the 5th metacarpophalangeal joint that was successfully reduced by volar open reduction without splitting the volar plate.
Dislocations ; Joints ; Metacarpophalangeal Joint ; Palmar Plate

Traumatic boutonniere deformity of the thumb is rare in non-rheumatoid patients. Non-rheumatoid patient develops a boutonniere deformity of the thumb following a closed injury to the dorsoradial aspect of the metacarpophalangeal joint. The patient had an extensor lag of the metacarpophalangeal joint and paradoxical hyperextension of the interphalangeal joint. The patient required surgical treatment which included advancement and reattachment of the extensor pollicis brevis insertion and imbrication of the dorsoradial capsule to restore the anatomical alignment of the extensor pollicis longus. Conservative care of the metacarpophalangeal joint may be effective, but once a boutonniere deformity is developed, surgical treatment is necessary.
Congenital Abnormalities* ; Humans ; Joints ; Metacarpophalangeal Joint ; Thumb*

Dislocation of index metacarpophalangeal joint is complex and usually cannot be reduced by closed method. It is a relatively rare injury and there are no widely published studies on its management. We have experienced a case combined with osteochondral fracture of the dorsoulnar aspect of metacarpal head and reduced it using extensor tendon splitting simplified technique with good results. This technique is seemed te be simpler and safer than volar approach described by Kaplan.
Dislocations ; Head ; Metacarpophalangeal Joint ; Methods ; Tendons

PURPOSE: To describe the surgical treatment of the complex dorsal metacarpophalangeal dislocations and its results, emphasizing on the modified volar approach with A1 pulley release. MATERIALS AND METHODS: We experienced 6 cases of dorsal dislocation of the metacarpophalangeal joint. We performed open reduction with the modified volar approach described by Eaton and Dray. Postoperatively posteroanterior and lateral radiographs of the index finger metacarpophalangeal joint and metacarpophalangeal joint range of motion was followed. RESULTS: One case with a large osteochondral fracture was operated with volar and doral approach both. Overall end results were good without any significant restriction of motion and stability of the fingers. CONCLUSION: Modified volar approach with A1 pulley release is an excellent method for complex dorsal metacarpophalangeal dislocations without osteochondral fracture.
Benzodiazepines ; Dislocations ; Fingers ; Metacarpophalangeal Joint ; Range of Motion, Articular

PURPOSE: We analyzed the results of treatment of dislocation of the extensor tendons over the metacarpophalangeal joints. MATERIALS AND METHODS: Thirteen patients who had received treatment for dislocation of the extensor tendons over the metacarpophalangeal joint were reviewed. Ten patients had traumatic dislocations, two had spontaneous dislocations, and one had congenital dislocation. The long finger was most frequently affected. The other fingers were affected almost equally. Displacement of the extensor tendon always occurred in the ulnar direction in the long and ring fingers. The index and little fingers exhibited different patterns of dislocation. RESULTS: Nonsurgical treatment was undertaken in two cases. Surgery was performed in 11 cases. No recurrent dislocations were reported in any of the patients. Conculsions: Based on our experience, patients seen within 2 weeks of injury initially should be treated with splinting of the involved metacarpophalangeal joint. Chronic dislocations should be treated with a primary repair of the defect in the sagittal band. When the sagittal band is absent or deficient, the tendon must be stabilized using a loop procedure with a tendon slip.
Dislocations ; Displacement (Psychology) ; Fingers ; Humans ; Metacarpophalangeal Joint ; Splints ; Tendons

OBJECTIVE: The purpose of this study was to identify the effect of EMG-triggered electrical neuromuscular stimulation for recovery of hemiplegic arm function. METHOD: EMG-triggered electrical stimulation was applied to the extensor digitorum communis (EDC) of 8 chronic hemiplegics who showed no functional changes for more than 3 months. Stimulation was started when the amplitude of processed EMG signal from the same muscle exceeded the preset threshold. The therapeutic effect was evaluated by kinesiologic and clinical methods before and after 4 weeks. Quantitative EMG from EDC, excursion of second metacarpophalangeal joint, and functional measurements were used. We also evaluated cognitive and perceptual effect on recovery of arm function. RESULTS: Subjects treated with EMG-triggered electrical stimulation showed significant gain in amplitude of quantitative EMG and excursion sum during maximal exertion comparing to those of pre-treatment (p<0.05). There was also an decrease of spasticity after treatment. But functional, perceptual and cognitive outcome were not changed significantly (p>0.05). CONCLUSION: These results suggest that EMG-triggered electrical stimulation might be an effective therapeutic modality to improve motor function of the hemiplegic arm of chronic brain injured patients.
Arm* ; Brain ; Electric Stimulation* ; Hemiplegia* ; Humans ; Metacarpophalangeal Joint ; Muscle Spasticity

Dislocation of the metacarpophalangeal joint of the finger is rare except thumb. We experienced a case of volar dislocation of little finger and 2 cases of dorsal dislocation of index finger. The mechanism of injury seems to be direct trauma to the dorsum of hand with the metacarpophalangeal joint acutely flexed in volar dislocation and the dorsal dislocation is forced the metacarpophalangeal joint into hyperextension. In 1957, Kaplan advocated the triple incision, that is release of the volar fibrocartilageous plate, the natatory ligament, and the superficial transverse metacarpal ligament, exposing the operation field through a palmar approach. The recommended treatment for such very rare injury is open reduction through nalmar approach in dorsal dislocation, and dorsal approach in volar dislocation; the single most important element preventing reduction is interposition of the volar plate within the joint space in dorsal dislocation and the obstacles of volar dislocation are entraped dorsal capsule and partial ruptured extensor tendon. In dorsal dislocation, we advocated only half release of volar fibrocartilage for lessor trauma of soft tissue and reduction was made easily after release of 1/2 volar fibrocartilage. We report this rare and interesting cases with review of literature.
Dislocations ; Fibrocartilage ; Fingers ; Hand ; Joints ; Ligaments ; Metacarpophalangeal Joint ; Tendons ; Thumb

The dislocation of metacarpophalangeal joint of the index is apparently rare injury and produeed by striking of the volar surface of the outstretched index against a resistent object. This injury presents certain characteristics which make it distinctly different from dislocation of the thumb or little finger. The proximal phalanx is displaced over the dorsum of the corresponding metacarpal, the hand is deformed, and the index is inclined toward the middle finger. In 1957 Kaplan reported his study about the pathological anatomy and proper treatment technique in the dislocation of the metacarpophalangeal joint of the index finger. In this type of dislocation, closed reduction, even if performed immediately after the injury, is unsuccessful, and open reduction is mandatory. The authors have experienced a case of dorsal dislocation of the metacarpophalangeal joint of the index finger developed 3 weeks prior to admission on 20 th, May, 1985.
Dislocations ; Fingers ; Hand ; Metacarpophalangeal Joint ; Strikes, Employee ; Thumb

Dislocation of the metacapophalangeal joint of the finger is apparently rare except thumb. The mecchanism of injury seems to be direct injury that produces hyperextension of metacapophalangeal joints. In 1957, Kaplan advocated the triple incision, that is release of the volar fibrocartilaginous plate, the natatory ligament, and the superficial transverse metacapal ligament, expose the operation field through palmar approach. In 1975. Becton advocate direct dorsal longitudinal incision. The advantages of this approach as compared with the volar approach are 1. There is full exposure of the fibrocartilaginous volar plate, the main structure blocking reduction. 2. Digital nerves are not as apt to be damaged. 3. Accurate reduction and fixation of the osteochondral fracture of the metacarpal head is possible. We exprenced 6 cases of index metacarpophalangeal dislocation and treated with dorsal approach.
Dislocations ; Fingers ; Head ; Joints ; Ligaments ; Metacarpophalangeal Joint ; Thumb