PMC8182208_01
Radiographs obtained in the emergency department upon presentation: (a) posteroanterior
view demonstrating widening of the index finger metacarpophalangeal joint and (b)
lateral view demonstrating index finger metacarpophalangeal joint dorsal dislocation
with small joint space opacity representing possible accessory ossicle.
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Radiographs demonstrated dorsal dislocation of the first MCP joint (Figure 1(a) and (b)).
Intraoperative fluoroscopy: (a) prereduction lateral view, (b) postreduction lateral
view, and (c) close up lateral image highlighting presence of sesamoid bone within the
joint.
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Intraoperative fluoroscopy confirmed dorsal translation of the proximal phalanx proximally to the metacarpal head (Figure 2(a)). After splitting the volar plate, the joint and the sesamoid bone were manipulated in a manner allowing reduction with gentle dorsal to volar pressure on the proximal phalanx, confirmed by fluoroscopy (Figure 2(b) and (c)).
Radiographs obtained on postoperative day 5: (a) posteroanterior view demonstrating
return to normal metacarpophalangeal joint space (blue arrow) after reduction as well as
minimal lateral deformity of the metacarpal head possibly reflecting associated fracture
(yellow arrow) and (b) lateral view.
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On postoperative day 5, the patient had no complaints and radiographs demonstrated maintained reduction of the left index MCP joint (Figure 3(a) and (b)).
Physical examination on postoperative day 19: (a) loose composite fist and (b)
extension with minimal extensor lag.
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He was doing well with no sensory deficits and was able to form a loose composite fist and extend his fingers to neutral (Figure 4(a) and (b)).