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DISLOCATION
Hanif Andhika W
MCP DISLOCATIONS
Epidemiology:
hyperextension injury
REDUCTION OF FINGER
DISLOCATION TECHNIQUE
Dorsal dislocations
Apply longitudinal traction with hyperextension,
followed by pressure to the dorsal aspect of the
base of the middle phalanx as the finger is
brought into flexion. Apply a dorsal splint with
20-30 of flexion.
If an associated fracture of the volar lip affects
more than 33% of the joint surface, a closed
reduction will be unstable and operative repair is
necessary because the collateral ligament is
attached to the bony fragment.
LATERAL DISLOCATIONS
Apply longitudinal traction and ulnar or radial
stress to the finger, depending on the initial
direction of injury. Partial tears can be buddy-
taped; reduced dislocations (ie, complete tears)
should be splinted.
VOLAR DISLOCATIONS
Apply mild traction with the PIP and
metacarpophalangeal (MCP) joints flexed. Splint
only the PIP joint in full extension. Some argue
that all volar PIP joint dislocations should be
reduced in the operating room, on the grounds
that entrapment of the lateral band around the
head of the proximal phalanx may block
reduction
METACARPOPHALANGEAL JOINT