Dorsal Approach in the Surgical Treatment of Complex Dorsal Dislocation of Index Metacarpophalangeal Joint; a Case Report

Complex metacarpophalangeal (MCP) joint dislocation is an uncommon entity, which occurs following a hy-perextension injury. Closed reduction is not feasible due to entrapped volar plate and/or coexisting fractures.Various approaches and techniques have been proposed for treatment of complex MCP dislocation; however,controversies exist over which one is superior. This study describes a right-handed 14-year-old boy who fellon the outstretched hand and sustained a dorsal dislocation of the left index MCP joint. The dislocation wascomplicated by an epiphyseal metacarpal head fracture with dorsal-ulnar displacement of the osteochondralfragment. The patient underwent open reduction through the dorsal approach, and the metacarpal head wasfixed via the two-screw technique. The patient resumed left-hand function after six weeks. At the two-yearfollow-up, the range of motion and grip strength were normal, the patient was pain-free, and no sign of growthdisturbance or joint stiffness was detected. Dorsal surgical approach with screw fixation is a feasible techniquefor the treatment of complex MCP dislocation, especially when it is complicated by a large epiphyseal headfracture.