Revised: October 29, 2013
Accepted: November 15, 2013
Published online: January 18, 2014
Here, we present the clinical and radiological results of three neglected volar metacarpophalangeal dislocations in 2 patients, which were treated with open reductions 10 and 24 mo after the dislocations. There was a mean of a 20° (range 10°-30°) limitation of extension and a 53.3° (range 30°-70°) limitation of flexion preoperatively. Postoperatively, there was no limitation of extension (at 8 and 12 mo) in any of the fingers. In terms of flexion, one finger had full function, one had a 10° and the last one had a 30° limitation of flexion. Two of the fingers presented anesthesia preoperatively, which improved to hypesthesia postoperatively. One finger had hypesthesia, which improved postoperatively. During surgery, a ruptured dorsal capsule was found to have interposed into the joint, making closed reduction impossible. Our experience with these two patients demonstrated that, even in neglected cases, open reduction using an isolated dorsal approach may result in satisfactory clinical and radiological outcomes.
Core tip: Irreducible complex metacarpophalangeal (MP) dislocations are rare. Volar MP dislocations are very rare. There are no data in the literature reporting volar MP dislocations. We also observed neglected volar MP dislocations in our study. A dorsal or volar approach can be applied toward the surgical treatment of MP joint dislocations. In this study, we observed that isolated dorsal open reduction and K wire fixation results in a successful functional outcome in neglected volar MP dislocations. Volar exposure was not necessary for reduction and stabilization.