Complex dislocations of the metacarpophalangeal joints

Complex dislocations of the metacarpophalangeal joints, those blocked by soft tissue interposition, occur infrequently and are often misdiagnosed and mishandled. While these injuries can be treated in a closed fashion, they may actually be induced by incorrect technique in reducing simple MP dislocations. Open surgical reduction is the treatment of necessity, although there is currently no consensus on approach. This article presents an overview of the history, pathoanatomy, and clinical and radiographic findings of this fairly uncommon hand injury. The literature on the various treatment modalities is reviewed, and therapeutic guidelines are offered.