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

The extension type locked metacarpophalangeal joint of the little finger is an extremely rare condition characterized by loss of flexion with little or no loss of extension. The most common cause for locking is entrapment of a strap of the ruptured palmar plate. We treated a locked metacarpophalangeal joint of the little finger due to a hyperextension injury. The mechanism of locking was a torn part of the palmar ligament that forcefully rides across the prominence of the radial condyle of the metacarpal bone together with the accessory collateral ligament. These dislocated parts of the ligament formed a constricting bundle that prevented closed reduction. Locking was released successfully by an open reduction using the dorsal approach of the metacarpophalangeal joint without complication.
Collateral Ligaments ; Fingers* ; Ligaments ; Metacarpophalangeal Joint* ; Palmar Plate

Posttraumatic volar instability of the thumb metacarpophalangeal joint with hyperextensile laxity makes pain and weakness during pinch or grip exercise. Several surgical procedures have been described to eliminate thumb metacarpophalangeal joint hyperextension. We treated a patient who had suffered from volar instability with pain for 17 years using volar plate repair and capsulodesis with suture anchor. The result was successful with satisfactory recovery of the hand function.
Hand ; Hand Strength ; Humans ; Metacarpophalangeal Joint ; Suture Anchors ; Thumb ; Palmar Plate

Simultaneous double injury of the thumb at the interphalangeal joint and metacarpophalangeal joint occurring at the same time are seldom seen in medical practice. 72 year old male had posterior discation of interphalangeal joint and ulnar collateral ligament injury of metacarpophalangeal joint, as known as skier's thumb after he fell down from the bike. Open posterior dislocation of interphalangeal joint was stabilized by reduction and then skin suture was done. Metacarpophalangeal joint had totally ruptured ulnar collateral ligament with Stener lesion and bony fragment of base of proximal phalanx. The joint was subluxated and was not reduced due to jammed bony fragment. Displaced avulsion fracture of volar plate with ulnar collateral ligament injury was not reported by author's research. The author reduced bony fragment in joint and repaired ulnar lateral ligament. It has been 6 month after the operation and the patient is followed up. The patient has normal range of motion without instability of metacarpophalangeal and interphalangeal joint. We report our experience about simultaneous double injury of thumb and bony skier's thumb.
Collateral Ligaments ; Dislocations ; Humans ; Joints ; Male ; Metacarpophalangeal Joint ; Reference Values ; Skin ; Sutures ; Thumb ; Palmar Plate

Locking of the metacarpophalangeal(MP) joint of thumb in mild hyperextension is relatively uncommon problem. The most frequently recognized cause appears that proximal palmar ligament or volar plate were ruptured tranversely with its distal part riding over the volar prominence of the radial condyle of the first metacarpal head. We experienced two cases of locking of the MP joint of the thumb due to volar plate injury. Closed reduction was failed in both cases and open reduction was done by cutting the constricted ligament hundle over the radial condyle of the first metacarpal head. Our description of this mechanism is supported by expeimental evidence that we obtained from the cadeveric specimens. The height of radial side condyle of first metacarpal head is higher than ulna side of that by 1.76mm in both hands of 16 cadeveric specimen. So we are going to report these cases with a review of the literature, and suggest that the preferable location of surgical incision in open reduction is radial side of metacarpal head.
Hand ; Head* ; Joints ; Ligaments ; Metacarpal Bones* ; Metacarpophalangeal Joint* ; Thumb* ; Ulna ; Palmar Plate

A 17-year-old male experienced pain on his right outstretched hand due to a motor cycle accident. The diagnosis was obtained by clinical examination and simple radiography, closed reduction failed in the emergency room. Under general anesthesia, open reduction was performed by volar plate incision via the dorsal approach. A short arm splint was applied for 3 weeks and later ROM exercise produced a good result.
Adolescent ; Anesthesia, General ; Arm ; Diagnosis ; Dislocations* ; Emergency Service, Hospital ; Fingers* ; Hand ; Humans ; Male ; Metacarpophalangeal Joint* ; Radiography ; Splints ; Palmar Plate

PURPOSE: To report the clinical outcomes of a volar plate reinforcing technique with free tendon grafts after sesamoid excision for the surgical treatment of subsesamoid arthritis of the metacarpophalangeal (MCP) joint of the thumb. MATERIALS AND METHODS: Eleven consecutive patients that underwent sesamoid excision and volar plate reinforcement using a palmaris longus free tendon graft were enrolled. There were 7 males and 4 females, with an average age of 46 (range, 30-56 years). Post-traumatic arthritis after a hyperextension injury of the thumb was present in 9 patients. Two patients had idiopathic arthritis. All patients were evaluated by objective and subjective criteria, the mean follow-up duration was 19 months (range, 12-35 months). RESULTS: The results were satisfactory overall (3 excellent, 7 good, 1 poor). The mean grip strength and pinch strength significantly improved from 63.0% and 51.3%, respectively, preoperatively, to 84.9% and 88.9%, postoperatively. The mean range of motion for the MCP joint was -5.9/50.9 degrees. The mean DASH and MHQ scores showed significant improvement compared to the preoperative scores. CONCLUSION: The early clinical results suggest that the described technique is a safe and effective option for subsesamoid arthritis of the MCP joint of the thumb.
Arthritis ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Joints ; Male ; Metacarpophalangeal Joint ; Pinch Strength ; Range of Motion, Articular ; Reinforcement (Psychology) ; Tendons ; Thumb ; Transplants ; 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