Elghoul Naoufal, Bouya Ayoub, Jalal Youssef, Zaddoug Omar, Benchakroun Mohamed, Jaafar Abdeloihab
Department of Orthopedic Surgery and Traumatology, Military Hospital Mohammed V (HMIMV), University Mohamed V Faculty of Medecine and Pharmacy, BP 10100 Rabat, Morocco.
Trauma Case Rep. 2019 Jul 25;23:100225. doi: 10.1016/j.tcr.2019.100225. eCollection 2019 Oct.
Dislocation of the metacarpophalangeal joint is a rare injury. The index finger is most frequently involved, followed by the thumb; the little finger is very seldom affected. The Complex dislocation of the little finger metacarpophalangeal joint is extremely rare. A few cases only had been described. Herein, we report a case of 40 years old presented, after a road accident, a dorsal metacarpophalangeal joint dislocation of the litter finger confirmed on radiographs with a clear view of the sesamoid bone within joint prompting the patient to undergo open reduction with no attempts of closed reduction initially. We elected, to treat our case, for the volar approach which allowed successful relocation of the head of the metacarpal in its anatomical position. The view of sesamoid bone within the joint is pathognomonic of volar plate entrapment. Recognition of this fact should alert the treating physician to the inevitability of open reduction for anatomical repositioning of the joint and avoid repeated attempts at closed reduction which may arise the risk of degenerative arthritis and reduced final range of motion.
掌指关节脱位是一种罕见的损伤。食指最常受累，其次是拇指；小指很少受到影响。小指掌指关节复合脱位极为罕见。仅报道过少数病例。在此，我们报告一例40岁患者，在道路交通事故后，经X线片证实小指掌指关节背侧脱位，关节内籽骨清晰可见，促使患者最初未尝试闭合复位而直接接受切开复位。我们选择采用掌侧入路治疗该病例，该入路使掌骨头成功复位至解剖位置。关节内籽骨的显影是掌板嵌顿的特征性表现。认识到这一事实应提醒治疗医生，为使关节解剖复位进行切开复位是不可避免的，应避免反复尝试闭合复位，因为这可能会增加退行性关节炎的风险并减少最终的活动范围。
