Fractura de Bennet con luxación metacarpofalángica del pulgar asociada Associated Bennett's fracture and metacarpophalangeal dislocation of the thumb
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Summary. We report a rare case of simultaneous Bennetts fracture and metacarpophalangeal open volar dislocation of the thumb. The Bennetts fracture was treated by percu- taneous pinning. The open volar dislocation was reduced and the collateral ligaments, the extensor tendons, and the dorsal capsule, were surgically repaired. An infection of the metacarpophalangeal joint appeared four weeks later, which was treated by surgical drainage and antibiotic the- rapy. The resultant damage of this joint was treated by arth- rodesis with an external fixator.Keywords:
Metacarpophalangeal joint
Metacarpus
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Metacarpophalangeal joint
Metacarpus
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Objective To investigate therapeutic efficacy of the internal fixation in the closed dislocation of the proximal interphalangeal joint(PIP joint) with the volar basal fracture of the middle phalanx.Methods 20 patients with closed dislocation of the PIP joint with the volar basal fracture of the middle phalanx accepted Kischner wire fixation treatment,splint protection for 3 to 4 weeks and rehabilitation after operation.Results 20 patients all have been followed up after operation over a period of 3 to 6 months,the image evaluation showed the reduced and united of the bone fracture.The active range of motion at the PIP joint was 0~20(18±1)°in extension and 30~90(68±5)°in flexion;the passive range of motion was 5~20(15±2)°in extension and 50~100(78±8)°in flexion.Conclusions The therapeutic efficacy is satisfactory with internal fixation in the treatment to the closed dislocation of the PIP joint with the volar basal fracture of the middle phalanx.
Interphalangeal Joint
Phalanx
Distal interphalangeal joint
Middle finger
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Metacarpophalangeal joint
Avulsion fracture
Interphalangeal Joint
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Metacarpophalangeal joint
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A volar dislocation of the metacarpophalangeal (MCP) joint of the thumb is a rare trauma, and in combination with a radial collateral ligament (RCL) injury is much rarer. We present a surgical case with a recurrent volar dislocation of the MCP joint of the thumb with RCL injury. A 47-year-old man was referred to our hospital in the subacute phase. Open reduction was performed through a dorsal incision and the RCL was repaired. X-rays taken six weeks later revealed a recurrent dislocation of the MCP joint. At the revision surgery, the extensor pollicis brevis (EPB) was detached from the proximal phalanx. As there was volar tightness, the volar plate was incised horizontally and the EPB was attached to the proximal phalanx. The final X-rays six months post-operatively revealed that the MCP joint was slightly subluxated but there was no pain on motion. This case revealed that it is not enough only to repair the RCL to reduce a volar dislocation of the MCP joint of the thumb with an RCL injury. It revealed that re-attachment of the extensor tendons and the volar procedure are also important for a perfect reduction of a recurrent volar dislocation of the MCP joint of the thumb. For a volar dislocation of the MCP joint of the thumb with RCL injury, it is important not only to repair the RCL, but also to perform arthroplasty with the extensor tendons and a volar procedure to prevent recurrent dislocation after surgery.
Metacarpophalangeal joint
Proximal phalanx
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A case of inveterate dorsal dislocation of the MCP joint of the thumb treated by open reduction and tendon reinforcement of the volar capsule. The paper reports rare cases of inveterate, complete dorsal dislocation of the thumb MCP joint. After open reduction there was a full passive flexion but dorsal dislocation recurred. The tendency to return of dislocation was abolish by tendon reinforcement of the capsule of the joint described by Kessler. Follow up studies revealed no significant instability, the range of motion was between 20 degrees and 55 degrees of flexion.
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We present an 18 year-old patient with a volar dislocation of the metacarpophalangeal joint of the thumb. Open reduction was performed through a dorsal incision. Because of the soft tissue interposition such as dorsal capsule, volar plate, dislocated extensor pollicis longus and brevis tendons, ruptured ulnar collateral ligament; open reduction, soft tissue and ligament repair are recommended for this type of thumb dislocations.
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Dislocation and fracture-dislocation of Carpometacarpal (CM) joints except for the thumb are relatively rare. In particular, volar dislocation of CM joints are very rare.We experienced one case of volar fracture-dislocation of the 2nd CM joint, and dislocation of the 3rd, 4th, 5th CM joints.A 25 year-old woman was involved in a motorcycle accident, sustaining an injury to her right hand.On examination she had a swollen left hand, and she complained of pain in her left hand.The XP findings showed volar fracture-dislocation of the 2nd CM joint, and volar dislocation of the 3rd, 4th, 5th CM joints.Closed reduction was performed, but instability of the 2nd CM joint remained.We therefore performed percutanous fixation, which was removed 8 weeks after the operation.Twenty weeks post-operatively the patient has no problems with her left hand.
Carpometacarpal joint
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Carpometacarpal joint
Hand surgery
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We report a case of palmar dislocation of a finger metacarpophalangeal joint. Disruption of all the supporting structures of this joint and rupture of the flexor tendon sheath caused marked instability. Treatment was by open reduction and repair of the collateral ligaments.
Metacarpophalangeal joint
Finger joint
Little finger
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