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Hand Dislocations

The Pediatric Upper Extremity

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Abstract

Finger dislocations are incredibly common injuries. They are very common in the pediatric athletic population. They are most frequently reduced on the playing field by athletic trainers, but are also seen in the Emergency Department. Most often, they are simple dislocations which are easily reducible. Finger dislocations can occur anywhere along the digits: the carpometacarpal joint, the metacarpophalangeal joint, the proximal interphalangeal joint, and the distal interphalangeal joint.

Not all dislocations are easily reducible, and some need operative intervention to reduce the joint. There are several structures specific to each joint which can impede a stable reduction. A stable reduction is essential to proper long term function of the digit and the hand as a whole. Proper knowledge of both closed and open methods of joint reduction are essential for orthopaedists and hand surgeons alike.

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References

  • Albertoni WM. The Brooks and Graner procedure for correction of mallet finger. In: Tubiana R, ed. The Hand. Vol 3. Philadelphia, Pa: WB Saunders; 1988;97–100.

    Google Scholar 

  • al-Qattan MM, Robertson GA. An anatomical study of the deep transverse metacarpal ligament. J Anat. 1993;182(Pt 3):443–6.

    PubMed Central  PubMed  Google Scholar 

  • Baldwin LW, Miller DL, Lockhart LD, Evans EB. Metacarpophalangeal-joint dislocations of the fingers. J Bone Joint Surg Am. 1967;49(8):1587–90.

    CAS  PubMed  Google Scholar 

  • Barenfeld PA, Weseley MS. Dorsal dislocation of the metacarpophalangeal joint of the index finger treated by late open reduction. A case report. J Bone Joint Surg Am. 1972;54(6):1311–3.

    CAS  PubMed  Google Scholar 

  • Bean CHG, Tencer AF, Trumble TE: The effect of thumb metacarpophalangeal ulnar collateral ligament attachment site on joint range of motion: an in vitro study, J Hand Surg [Am]. 1999;24:283–287.

    Article  CAS  Google Scholar 

  • Beatty E, Light TR, Belsole RJ, Ogden JA. Wrist and hand skeletal injuries in children. Hand Clin. 1990;6(4):723–38.

    CAS  PubMed  Google Scholar 

  • Becton JL, Christian Jr JD, Goodwin HN, Jackson 3rd JG. A simplified technique for treating the complex dislocation of the index metacarpophalangeal joint. J Bone Joint Surg Am. 1975;57(5):698–700.

    CAS  PubMed  Google Scholar 

  • Bohart PG, Gelberman RH, Vandell RF, Salamon PB. Complex dislocations of the metacarpophalangeal joint. Clin Orthop Relat Res. 1982;164:208–10.

    PubMed  Google Scholar 

  • Burman M. Irreducible hyperextension dislocation of the metacarpophalangeal joint of a finger. Bull Hosp Joint Dis. 1953;14(2):290–1.

    CAS  PubMed  Google Scholar 

  • Campbell Jr RM. Operative treatment of fractures and dislocations of the hand and wrist region in children. Orthop Clin North Am. 1990;21(2):217–43.

    PubMed  Google Scholar 

  • Cornwall R. Pediatric finger fractures: which ones turn ugly? J Pediatr Orthop. 2012;32 Suppl 1:S25–31.

    Article  PubMed  Google Scholar 

  • Dinh P, Franklin A, Hutchinson B, Schnall SB, Fassola I. Metacarpophalangeal Joint Dislocation. Journal of the American Academy of Orthopaedic Surgeons. 2009;17(5):318–324.

    PubMed  Google Scholar 

  • Dinowitz M, Trumble T, Hanel D, Vedder NB, Gilbert M. Failure of cast immobilization for thumb ulnar collateral ligament avulsion fractures. J Hand Surg Am. 1997;22(6):1057–63.

    Article  CAS  PubMed  Google Scholar 

  • Eaton RG. Joint injuries of the hand. Springfield: Charles C. Thomas; 1971.

    Google Scholar 

  • Gilbert A. Dislocation of the MCP joints in children. In: Tubiana R, ed. The Hand. Philadelphia: W.B. Saunders, 1985.

    Google Scholar 

  • Green DP, Terry GC. Complex dislocation of the metacarpophalangeal joint. Correlative pathological anatomy. J Bone Joint Surg Am. 1973;55(7):1480–6.

    CAS  PubMed  Google Scholar 

  • Harley BJ, Werner FW, Green JK. A biomechanical modeling of injury, repair, and rehabilitation of ulnar collateral ligament injuries of the thumb, J Hand Surg [Am]. 2004; 29:915–920.

    Article  Google Scholar 

  • Höglund M, Tordai P, Muren C. Diagnosis by ultrasound of dislocated ulnar collateral ligament of the thumb. Acta Radiol. 1995;36(6):620–5.

    Article  PubMed  Google Scholar 

  • Hunt JC, Watts HB, Glasgow JD. Dorsal dislocation of the metacarpophalangeal joint of the index finger with particular reference to open dislocation. J Bone Joint Surg Am. 1967;49(8):1572–8.

    CAS  PubMed  Google Scholar 

  • Kaplan EB. Dorsal dislocation of the metacarpophalangeal joint of the index finger. J Bone Joint Surg Am. 1957;39(5):1081–6.

    PubMed  Google Scholar 

  • Kozin SH. Treatment of thumb ulnar collateral ligament ruptures with the Mitek bone anchor. Ann Plast Surg. 1995;35(1):1–5.

    Article  CAS  PubMed  Google Scholar 

  • Kozin SH. Fractures and dislocations along the pediatric thumb ray. Hand Clin. 2006;22(1):19–29.

    Article  PubMed  Google Scholar 

  • Kozin SH, Bishop AT. Gamekeeper’s thumb. Early diagnosis and treatment. Orthop Rev. 1994;23(10):797–804.

    CAS  PubMed  Google Scholar 

  • Kuz JE, Husband JB, Tokar N, McPherson SA. Outcome of avulsion fractures of the ulnar base of the proximal phalanx of the thumb treated nonsurgically. J Hand Surg Am. 1999;24(2):275–82.

    Article  CAS  PubMed  Google Scholar 

  • Light TR, Ogden JA. Complex dislocation of the index metacarpophalangeal joint in children. J Pediatr Orthop. 1988;8(3):300–5.

    Article  CAS  PubMed  Google Scholar 

  • Mayer, SW, Ruch DS, Leversedge FJ. The Influence of Thumb Metacarpophalangeal Joint Rotation on the Evaluation of Ulnar Collateral Ligament Injuries: A Biomechanical Study in a Cadaver Model. The Journal of hand surgery 2014;39(3):474–479.

    Article  PubMed  Google Scholar 

  • McLaughlin HL. Complex “locked” dislocation of the metacarpophalangeal joints. J Trauma. 1965;5(6):683–8.

    Article  CAS  PubMed  Google Scholar 

  • Milch H. Subluxation of the index metacarpophalangeal joint; case report. J Bone Joint Surg Am. 1965;47:522–3.

    CAS  PubMed  Google Scholar 

  • Murphy AF, Stark HH. Closed dislocation of the metacarpophalangeal joint of the index finger. J Bone Joint Surg Am. 1967;49(8):1579–86.

    CAS  PubMed  Google Scholar 

  • O’Brien ET. Fractures of the hand and wrist region. In: Rockwood CA, Wilkins KE, King RE, editors. Fractures in children. 3rd ed. Philadelphia: Lippincott; 1991.

    Google Scholar 

  • Ogden JA. Skeletal injury in the child. Philadelphia: Lea & Febiger; 1982.

    Google Scholar 

  • Paschos, NK, et al. Management of Proximal Interphalangeal Joint Hyperextension Injuries: A Randomized Controlled Trial. The Journal of hand surgery 2014;39(3):449–454.

    Article  PubMed  Google Scholar 

  • Plancher, KD. MasterCases: Hand and Wrist Surgery. New York: Thieme, 2004;301–303.

    Google Scholar 

  • Rimmer CS, Burke D. Proximal interphalangeal joint hyperextension injuries in children. Emerg Med J. 2009;26(12):854–6.

    Article  CAS  PubMed  Google Scholar 

  • Sollerman C, Abrahamsson SO, Lundborg G, Adalbert K. Functional splinting versus plaster cast for ruptures of the ulnar collateral ligament of the thumb. A prospective randomized study of 63 cases. Acta Orthop Scand. 1991;62(6):524–6.

    Article  CAS  PubMed  Google Scholar 

  • Spaeth HJ, Abrams RA, Bock GW, Trudell D, Hodler J, Botte MJ, Petersen M, Resnick D. Gamekeeper thumb: differentiation of nondisplaced and displaced tears of the ulnar collateral ligament with MR imaging. Work in progress. Radiology. 1993;188(2):553–6.

    Article  CAS  PubMed  Google Scholar 

  • Stener B. Displacement of the ruptured ulnar collateral ligament of the metacarpophalangeal joint. J Bone Joint Surg Br. 1962;44(4):869–79.

    Google Scholar 

  • Waters PM. Problematic pediatric wrist and hand injuries. J Pediatr Orthop. 2010;30 Suppl 2:S90–5.

    Article  Google Scholar 

  • Weber DM, Kellenberger CJ, Meuli M. Conservative treatment of stable volar plate injuries of the proximal interphalangeal joint in children and adolescents: a prospective study. Pediatr Emerg Care. 2009;25(9):547–9.

    Article  PubMed  Google Scholar 

  • White GM. Ligamentous avulsion of the ulnar collateral ligament of the thumb of a child. J Hand Surg Am. 1986;11(5):669–72.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Hand, Microsurgery and Reconstructive Orthopedics, 300 State Street, Suite 205, Erie, PA, 16507, USA

    John Lubahn & Rey Ramirez

  2. UPMC Hamot Medical Center, Erie, PA, USA

    Raymond Metz & Patrick Emerson

  3. Core Orthopedics and Sports Medicine, 300 State Street, Suite 205, Elk Grove Village, IL, USA

    Raymond Metz

Authors
  1. John Lubahn
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  2. Rey Ramirez
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  3. Raymond Metz
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  4. Patrick Emerson
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Corresponding author

Correspondence to John Lubahn .

Editor information

Editors and Affiliations

  1. Dept. of Orthopedics, U. of Maryland School of Medicine, Timonium, Maryland, USA

    Joshua M. Abzug

  2. Shriners Hospital for Children - Phila., Philadelphia, Pennsylvania, USA

    Scott Kozin

  3. Shriners Hospital For Children - Phila., Philadelphia, Pennsylvania, USA

    Dan A. Zlotolow

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Lubahn, J., Ramirez, R., Metz, R., Emerson, P. (2014). Hand Dislocations. In: Abzug, J., Kozin, S., Zlotolow, D. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8758-6_46-1

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  • DOI: https://doi.org/10.1007/978-1-4614-8758-6_46-1

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  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-8758-6

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Chapter history

  1. Latest

    Hand Dislocations in Children
    Published:
    04 September 2023

    DOI: https://doi.org/10.1007/978-1-4614-8758-6_46-2

  2. Original

    Hand Dislocations
    Published:
    20 June 2014

    DOI: https://doi.org/10.1007/978-1-4614-8758-6_46-1

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