J Hand Microsurg 2016; 08(01): 013-016
DOI: 10.1055/s-0035-1571262
Original Article
Society of Indian Hand & Microsurgeons

Clinical Outcome of Metacarpophalangeal Joint Dislocation of the Thumb in Children: Case Series of 10 Patients

Omar Khursheed
1   Department of Orthopaedics, Government Medical College, Srinagar, India
,
Ansarul Haq
1   Department of Orthopaedics, Government Medical College, Srinagar, India
,
Shakir Rashid
1   Department of Orthopaedics, Government Medical College, Srinagar, India
,
Nazeefa Manzoor
1   Department of Orthopaedics, Government Medical College, Srinagar, India
,
Sarwar Shiekh
2   Department of Orthopaedics, SKIMS Medical College, Srinagar, India
,
Muzaffar Mushtaq
2   Department of Orthopaedics, SKIMS Medical College, Srinagar, India
› Author Affiliations
Further Information

Publication History

14 February 2015

23 November 2015

Publication Date:
27 April 2016 (online)

Abstract

Objectives Dislocation of the metacarpophalangeal joint of the thumb in children is an uncommon entity. The aim of this study was to evaluate the clinical outcome of pediatric patients with metacarpophalangeal joint dislocation of the thumb.

Patients and Methods Ten pediatric patients with metacarpophalangeal joint dislocation of the thumb were evaluated. Patients were studied prospectively over a period of 3 years. Parameters studied included patient demographics, type of dislocation, management, and any complications.

Results Mean age of patients was 6.8 years (range: 3–12 years). Seven patients underwent closed reduction and three patients were managed by open reduction. Of the total 10 patients, excellent results were obtained in 9 patients. One of the patients who reported on the fourth day of trauma and was managed by open reduction had mild joint stiffness with a range of motion of 10 to 40 degrees at final follow-up. None of these patients had infection or instability.

Conclusion After thorough clinical and radiological examination, closed reduction can be done in incomplete and simple complete dislocations of metacarpophalangeal joint of the thumb. Repeated closed reduction should be avoided in complex complete injuries. Early mobilization is advised to prevent joint stiffness.

Note

Informed consent was taken from each patient's parent after explaining details of study in local language. Manuscript has been read and approved by all the authors, and has not been submitted to or is not under consideration for publication in another journal.


 
  • References

  • 1 Ip KC, Wong LY, Yu SJ. Dorsal dislocation of the MCP joint of the thumb: a case report. J Orthop Surg (Hong Kong) 2008; 16 (1) 124-126
  • 2 Mata SG, Overjero AH, Grande MM. Volar dislocation of first metacarpophalangeal joint: a case report and review of the literature. Acta Orthop Belg 1991; 57 (3) 323-329
  • 3 Maheshwari R, Sharma H, Duncan RDD. Metacarpophalangeal joint dislocation of the thumb in children. J Bone Joint Surg Br 2007; 89: 227-229
  • 4 Canale ST, Beaty JH. Campbell's Operative Orthopaedics. Vol. IV. 11th ed. 2008: 3931-3933
  • 5 Türker T, Sheppard JE. Emergency open reduction for an irreducible dislocation of the metacarpophalangeal joint of the thumb in a child. J Hand Microsurg 2015; 7 (1) 166-169
  • 6 McLaughlin HL. Complex “locked” dislocation of the metacarpophalangeal joint. J Trauma 1965; 5: 683-688
  • 7 Kaplan EB. Dorsal dislocation of the metacarpophalangeal joint of the index finger. J Bone Joint Surg Am 1957; 39-A (5) 1081-1086
  • 8 Stener B. Hyperextension injuries to metacarpophalangeal joint of the thumb: rupture of the ligaments, fracture of the sesamoid bone, rupture of flexor pollicis brevis. An anatomical and clinical study. Acta Chir Scand 1963; 125: 275-293
  • 9 Somani AM, Uday D, Mahajan UD. Dorsal approach for open reduction of complex metacarpophalangeal joint dislocation: A case report. Int J healthc Biomed Res 2015; 3 (3) 241-245