Metacarpophalangeal Joint Dislocations Two Cases, Two Stories

Metacarpophalangeal (MCP) joint dislocation and its pathoanatomy was first discussed in detail in an article written by Kaplan et al . ,in 1957. They had identified certain features of complex, that is irreducible MCP joint dislocation through closed method to differentiate from a simple MCP joint dislocation, that is MCP joint dislocation that can be reduced by closed method. The complex MCP joint dislocations (mostly involving the index finger) are called Kaplan dislocations.Here, we describe two cases of MCP joint dislocations to highlight the differences between complex and simple MCP joint dislocation in their clinical appearances, X-rays, and management protocol.

In the first case, the injured patient was a 17-year-old young cricketer, who sustained the injury while playing the game. After careful clinical examination and studying the X-rays, we assured the patient and treated his injury by closed reduction method. After undergoing the post-reduction splinting and physiotherapy, the patient has recovered completely and he is back to playing cricket.In the second case, the patient was an elderly lady; she got her left index finger dislocated while trying to forcefully hold a moving object. After careful clinical examination and studying the X-rays, we counselled her and treated her injury through open reduction method. After following the post-operative splinting and physiotherapy, the patient is doing well but her index finger extension is restricted in the terminal ranges.

The MCP joint dislocations have distinctive clinico - pathological patterns and we should carefully study them. We should not hesitate to adopt open reduction techniques in appropriately indicated patients.