Locked metacarpophalangeal joint of the finger

Twenty-one patients who had received treatment for a locked metacarpophalangeal joint of an index finger were reviewed. Five cases were successfully treated with manipulation after an intra-articular injection of a local anesthetic, while the remaining 16 required open reduction. In the vast majority (15 of the 16 operated patients), the locking was attributed to catching of the radial accessory collateral ligament on a bony prominence of the metacarpal head of the finger. All patients who underwent manipulation, and 14 of the 16 patients who were operated on, regained full range of motion of the metacarpophalangeal joint with no pain. Our experience suggests that manipulation is the treatment of choice. However, if it is unsuccessful, it should be followed by surgical exploration to avoid further damage to the joint.