The surgical approach in non-border digit complex dislocations of the metacarpophalangeal joint.

Complex dislocations of the metacarpophalangeal (MCP) joint of the hand are uncommon. Most are irreducible by closed means and require open reduction. The structure most frequently blocking reduction is the volar plate, which is often interposed between the metacarpal head and the base of the proximal phalanx by the partially torn deep transverse metacarpal ligaments and MCP collateral ligaments. A review of the literature reveals controversy concerning which surgical approach, dorsal or volar, should be used to reduce these dislocations. We present an unusual case of a closed dorsal complex dislocation of the middle finger MCP joint to advocate the dorsal approach.