2 CASES OF OPEN COMPLEX KAPLAN’S DISLOCATION OF THUMB AND OF 2ND TO 4TH METACARPOPHALYNGEAL JOINT ASSOCIATED WITH IPSILATERAL ANTERIOR SHOULDER DISLOCATION; A RARE CASE REPORT

Dr. Mihir Desai*, Dr. Dhrumin Sangoi and M. S. Orthopaedics

ABSTRACT

Dorsal metacarpophalyngeal dislocations are uncommon variety of hand injuries. Especially when they are open type. Open type of Dorsal Metacarpophalyngeal dislocation of the 1st ray or the Thumb are even more uncommon. We report two cases, one having open type of metacarpophalyngeal dislocations of 2nd to 4th fingers except little finger and other having open type of Metacarpophalyngeal dislocation of the Thumb. Both were associated with Ipsilateral Anterior Shoulder Dislocation. According to our review of literature, ipsilateral shoulder dislocation have not been reported with such injuries. The pathognomonic feature of these injuries are fall on outstrectched fingers and a hyperextension force exerting on the metacarpophalyngeal joints. Simple or Complex variety of dislocations depends on whether the joint would get reduced by open or closed means. The characteristic finding of these type of injuries is the presence of an interspersed volar plate in between the metacarpophalyngeal joint either of the long fingers or the thumb. Both of our cases,inspite of being open in nature were irreducible by closed means and were of complex variety and had to be open reduced under vision after splitting the entrapped volar plate and tendons of FDP and in one case the metacarpophalyngeal joint of the thumb had to be fixed with 1 Kirschner wire. Both the patients had ipsilateral shoulder dislocation which were reduced in a closed fashion. Early anatomical reduction of the dislocated joints coupled with relatively early physiotherapy regimen gives good to excellent functional results as both in our patients. There are reports of isolated dorsal dislocations of metacarpophalyngeal joints of long fingers as well as of the thumb. But there are no reports mentioned in literature where there is associated ipsilateral shoulder dislocation. Both of our cases we had an open variety of Irreducible Complex Metacarpophalyngeal joint Dislocation as well as ipsilateral shoulder dislocation.

Keywords: Open; Complex MCP Joint dislocation; Ipsilateral shoulder dislocation.