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      Volar dislocation of the thumb metacarpophalangeal joint with acute repair of the ulnar collateral ligament

      case-report

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          Abstract

          Volar dislocations of the thumb metacarpophalangeal joint are uncommon and can be associated with rupture of the ulnar collateral ligament (UCL). We report a case where a volar thumb dislocation was successfully closed reduced, but instability required open repair of the UCL. Early motion protocol helped achieve favorable results.

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          Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint with an intraosseous suture anchor.

          A Weiland, S H Berner, R N Hotchkiss … (1997)
          Thirty-six consecutive patients with 37 complete tears of the ulnar collateral ligament of the thumb metacarpophalangeal (MP) joint were treated with primary repair using a miniature intraosseous suture anchor. Thirty patients were evaluated by clinical examination or by questionnaire at an average of 11 months after repair. Loss of interphalangeal joint motion averaged 15 degrees on the involved side versus the other side, while loss of MP joint motion averaged 10 degrees. There was no significant difference on stress testing measurements between repaired and nonrepaired thumbs. There were no instances of nerve injury, infection, device failure, or reoperation. The authors concluded that this is a safe and effective method for repair of complete tears of the ulnar collateral ligament of the thumb MP joint.
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            Thumb metacarpophalangeal joint collateral ligament injury management.

            Arthur Lee, Michelle Carlson (2012)
            The thumb collateral ligaments at the metacarpophalangeal joint are important to the elite athlete for precision grip and pinch. Injuries to these ligaments can result in pain and instability and are seen at a higher frequency at the elite level. Whereas the collateral ligament tears used to be associated primarily with recreational skier's injury, these injuries have been reported with increasing frequency in major professional sports. The ulnar collateral and radial collateral ligament injuries of the thumb occur through different mechanisms and are described in separate sections given the differences in their anatomy.
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              Palmar dislocation of the thumb metacarpophalangeal joint: report of four cases and a review of the literature.

              H Okamoto, H Senda (2014)
              We report four cases of palmar dislocation of the thumb metacarpophalangeal joint and review of an additional 22 cases in the literature. Our four cases were associated with ligamentous injuries that prevented stable closed reduction. The patients were treated with open reduction and ligament repair and ultimately had a decreased range of motion. Our four cases and the 22 cases from literature fall into three types: Type A - stable joint (the metacarpophalangeal joint is stable, without severe ligament injury); Type B - tendon block (palmar displaced extensor tendons within the metacarpophalangeal joint prevents reduction); and Type C - joint instability (the metacarpophalangeal joint is unstable because of severe collateral ligament disruption). Type B is the most commonly reported type of palmar dislocation of the thumb metacarpophalangeal joint, with distinct features of the involvement of the collateral ligaments and failure of attempted manual reduction. The patients without severe collateral ligament disruption were managed with conservative treatment. The patients with interposition of extensor tendons and the patients with instability resulting from severe ligamentous injuries require surgical treatment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Reports Plast Surg Hand Surg
                Journal ID (iso-abbrev): Case Reports Plast Surg Hand Surg
                Journal ID (archive): ICRP
                Journal ID (publisher-id): icrp20
                Title: Case Reports in Plastic Surgery & Hand Surgery
                Publisher: Informa Healthcare
                ISSN (Electronic): 2332-0885
                Publication date Collection: 2014
                Publication date (Electronic): 16 October 2014
                Volume: 1
                Issue: 1
                Pages: 5-7
                Affiliations
                [ a ]Department of Orthopaedic Surgery, Rutgers University- New Jersey Medical School , Newark, NJ 07101, USA
                [ b ]Department of Plastic Surgery, Rutgers University- New Jersey Medical School , 90 Bergen St, DOC 7100, Newark, NJ 07101, USA
                [ c ]Jersey City Medical Center , 355 Grand St, Jersey City, NJ 07302, USA
                Author notes
                Correspondence: Vishnu C. Potini, MD, Department of Orthopaedic Surgery, Rutgers University- New Jersey Medical School , 90 Bergen St, DOC 7300, Newark, NJ 07101, USA. +1 973 972 2150. potinivc@ 123456njms.rutgers.edu
                Article
                Publisher ID: 965254
                DOI: 10.3109/23320885.2014.965254
                PMC ID: 4627101
                PubMed ID: 27252947
                SO-VID: ad0f0283-c5d4-4b6a-a367-21d529cb2c8b
                Copyright © © 2014 The Author(s). Published by Informa Healthcare.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 16 July 2014
                Date revision received : 7 September 2014
                Date accepted : 10 September 2014
                Page count
                Figures: 2, Tables: 0, Equations: 0, References: 10, Pages: 3
                Categories
                Subject: Case Report

                Keywords: dislocation,metacarpophalangeal,thumb,ulnar collateral ligament
                Data availability:
                Keywords: dislocation, metacarpophalangeal, thumb, ulnar collateral ligament

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