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Kaplan's Lesion in a Child: A Case Report.

Abhishek Kumar Thakur¹, Nabees Man Singh Pradhan¹, Pramod Devkota¹

¹Department of Orthopedics and Trauma Surgery, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal.

JNMA; Journal of the Nepal Medical Association

|January 27, 2023

Summary

Kaplan's lesion, a rare metacarpophalangeal joint dislocation, requires open reduction in delayed cases. Successful surgical intervention restored full finger function after a 3-week delay.

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Area of Science:

Orthopedic Surgery
Pediatric Hand Surgery

Background:

Kaplan's lesion is an uncommon and complex metacarpophalangeal (MCP) joint dislocation.
Early diagnosis and management are crucial for optimal outcomes in pediatric hand injuries.

Observation:

A 7-year-old female presented with a 3-week history of right index finger pain, swelling, and immobility following a fall.
Radiographs revealed a complex dorsal MCP joint dislocation.

Findings:

Closed reduction attempts under anesthesia were unsuccessful due to the delayed presentation (3 weeks).
Open reduction via a dorsal approach was performed.
At 1-year follow-up, the patient experienced no pain and achieved full range of motion in the affected MCP joint.

Implications:

This case highlights the importance of considering Kaplan's lesion in the differential diagnosis of pediatric finger dislocations.
Open reduction can be an effective treatment for chronic or complex MCP joint dislocations in children.
Prompt surgical intervention, even in delayed presentations, can lead to excellent functional recovery.