Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Dislocation of MCP joint

Dislocation of the MCP joint is a rare injury. When it does occur the border digits (the index and little fingers) are most commonly affected. Dorsal dislocation of the MCP joint occurs following forced hyperextension (bending backwards) of the fingers. The volar (palm) plate is ruptured and the head of the metacarpal can sometimes be buttonholed through the volar plate and surrounding structures (complex dislocation). This can make reduction difficult. A characteristic dimple in the palm is often seen in this variety of dislocation.

Symptoms

– Pain occurs together with tenderness and impaired function.
– Deformity of the joint outline can be seen.
– For complex dislocations, a characteristic dimple may be present in the palm.

Treatment

The doctor may:
– reduce the joint back into its normal position. Failure of attempted closed reduction is typical of the complex dislocation;
– operate: open reduction is usually required for the complex dislocation;
– apply a splint to stop the finger from straightening all the way. This is worn for 2–3 weeks. Active motion in the splint should begin as early as possible to avoid stiffness. Buddy taping should be used during athletic competition for several months;
– X-ray the joint to make sure there is no fracture.

Protected early return to sport is usually possible.

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