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Surgical Management of Complex Metacarpophalangeal Joint Dislocation

March 15, 2015

Contributors: Matthew Hiro, MD; Randipsingh R Bindra, MD, FAAOS, FRACS, FRCS; Harold Fogel, MD; Harold Fogel, MD

Complex metacarpophalangeal (MP) joint dislocation results from a hyperextension force to a border digit. The dislocation is irreducible due to in-folding of the volar plate between the metacarpal head and proximal phalanx. The injury is rare and can be missed as clinical and radiographic findings are subtle. Furthermore, management is difficult as open reduction is required by a surgeon familiar with the peculiar anatomy of this injury. The aim of this video is to demonstrate the surgical anatomy of complex MP joint dislocation and the clinical and radiographic features for establishing the diagnosis using clinical examples. The video also shows the safe dorsal approach for open reduction of this injury and postoperative management in a clinical case. After review of the video, a general orthopaedic surgeon will be able to discuss the anatomic pathology and explain the technique for open reduction and postoperative care for this rare but complex injury.

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