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Thumb MCP Reduction 26705

thumb mcp dislocation xray 
CPT Coding Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:thumb MCP closed reduction, thumb metacarpophalangeal joint reduction, thumb mcp dislocation

 Thumb MCP Reduction CPT

Thumb MCP Reduction Indications

  • Simple dislocation of Thumb MCP joint

 Thumb MCP Reduction Contraindications

  • Complex dislocation prox phalanyx and metacarpal are parallel, volar plate is interposed, irreducible closed

Thumb MCP Reduction Alternatives

  • Open Reduction

Thumb MCP Reduction Technique

  • Closed reduction for dorsal dislocation: flex the wrist and the PIP joint to relax the flexor tendons. Apply pressure from dorsal to volar to the base of the proximal phalanx. 
  • Closed reduction for volar dislocation: Wrist and MCP joint is flexed, and gentle pressure applied to the volar surface of the proximal phalanx as it is brought into extension.

Thumb MCP Reduction Complications

  • Loss of reduction
  • Early degenerative arthritis
  • Osteonecrosis of the metacarpal head
  • Stiffness
  • Neurovascular injury

Thumb MCP Reduction Follow-up care

  • Early ROM with a dorsal blocking splint preventing extension beyond neutral.

Thumb MCP Reduction Outcomes

  • Generally good, small concerns for early degenerative arthritis, AVN of metacarpal head and stiffness. 

Thumb MCP Reduction Review References

  • Bohart PC, JBJS 56A:1459;1974
  • Dinh P, JAAOS 2009:17;318-324