Simultaneous ipsilateral proximal interphalangeal and metacarpophalangeal dislocation of the fifth phalanx: A case report
© Unay et al; licensee BioMed Central Ltd. 2008
Received: 18 July 2008
Accepted: 03 October 2008
Published: 03 October 2008
There is no case of simultaneous ipsilateral proximal interphalangeal and metacarpophalangeal dislocation of a finger in the literature.
A 61 years old male patient sustained an ipsilateral dorsal dislocation of the PIP joint of his fifth finger and dorsal dislocation of the metacarpophalangeal joint. Closed reduction of proximal interphalangeal joint was achieved while open reduction of the metacarpophalangeal joint was carried out.
The single most important element preventing reduction of the metacarpophalangeal joint was an interposition of the volar plate between proximal end of the phalanx and the head of the metacarpal.
In this report we aimed to investigate and discuss an extremely rare injury that is bipolar dislocation of the fifth proximal phalanx due to a fall on hand. Although, simultaneous dislocation of metacarpophalangeal and carpometacarpal joints of the same digit had been previously reported, we did not find any case of simultaneous ipsilateral proximal interphalangeal and metacarpophalangeal dislocation of a finger in the English speaking literature.
We did not find any case about a dorsal dislocation of an ipsilateral proximal interphalangeal and metacarpophalangeal joint (fifth phalanx dislocation) in the English speaking literature. Irreducible metacarpophalangeal dislocations are extremely rare injuries with buttonholing of the metacarpal head into the palm [1–3].
The most important element preventing reduction is an interposition of the volar plate between the base of the proximal phalanx and the head of metacarpal. In this case report, taking the advantage of a direct access to the metacarpal head we had preferred volar approach for an open reduction of a complex metacarpophalangeal dislocation.
To us, volar approach also has the advantage of an evaluating the integrity of the neurovascular bundle (digital nerve and artery) which are tented tightly over the metacarpal head.
Although, simultaneous dislocation of metacarpophalangeal and carpometacarpal joints of the same digit had been previously reported , simultaneous proximal interphalangeal and metacarpophalangeal dislocations of the same digit have not been discussed in the English literature and the patient consulting to the emergency unit with a trauma to his hand should be evaluated carefully for possible bipolar dislocation of fifth phalanx.
Written consent was obtained from the patient for publication of the study.
No funding has been received for the study.
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