MCP Dislocation
synonyms: MP dislocation, metacarpal phalangeal dislocation
MCP Dislocation ICD-9
- 834.01(closed)
- 834.11(open)
MCP Dislocation Etiology / Epidemiology / Natural History
- Result from fall on the outstretched hand.
MCP Dislocation Anatomy
- Volar plate, deep transverse metacarpal ligament may present barriers to reduction
- See Hand Anatomy.
MCP Dislocation Clinical Evaluation
- Generally have obvious pain and deformity of the PIP joint.
- Document neurovascular status of the finger before and after any reduction.
MCP Dislocation Xray / Diagnositc Tests
- A/P and lateral of affected digit.
MCP Dislocation Classification / Treatment
- Dorsal: unlikely to be reduced closed due to interpostion of the volar plate or buttonholing of the MC head between the flexor tendons and radial lumbrical. Open reduction: dorsal incision, split extensor tendon, divide volar plate longitudinally to allow reduction.
- Complex dislocation is characterized by bayonet apposition best seen on lateral view. Volar plate has been tramatically avulsed from its origin on the metacarpal with displacement into the MCP joint. Irreducible by closed means. Open reduction can be done by dorsal or palmar approaches. (Becton, JBJS 57A:698;1975).
- Thumb MCP subluxation / dislocation
MCP Dislocation Associated Injuries / Differential Diagnosis
MCP Dislocation Complications
- Tendon adhesion / stiffness
- Flexion Contracture
- Nerve or vascular injury
- Loss of reduction
MCP Dislocation Follow-up Care
- Post-op /Initial: Splint. Elevation.
- 7-10 Days: xray to ensure reduction is maintained. Activity modifications. Buddy tape digits. Mobilize as soon as possible.
- 6 Weeks: Continue activity modifications. Agressive ROM.
- 3 Months: Resume full activities. Assess ROM.
- 1Yr: assess outcomes / follow-up xrays.
MCP Dislocation Review References
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