Metacarpophalangeal Joint Dislocation Follow-up

  • Author: Matthew Gammons, MD; Chief Editor: Craig C Young, MD   more...
 
Updated: Mar 27, 2012
 

Return to Play

As with most injuries return to play in patients with metacarpophalangeal (MCP) joint dislocation will vary somewhat by the injury and desired activity. Some athletes will be able to return immediately as long as the injury can be adequately protected in a splint or cast. After the acute MCP joint injury has healed (usually 3-6 wks), the injured finger can be buddy taped for 1-3 weeks for additional protection and comfort. Some MCP joint injuries may require up to 3 months for full return to sporting activity if they cannot be protected or if the desired sport requires full use of the injured finger.

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Complications

Soreness and swelling may persist for many months after the capsule and ligaments have healed. Inadequate immobilization or early return to high-stress activities may result in ligamentous laxity or recurrent instability. Excessive immobilization or severe soft-tissue damage may lead to some joint stiffness, which is common after many of these injuries. Posttraumatic arthritis may occur after multiple closed reductions or unrecognized (chronic) dislocations. Digital nerve injury may occur during the volar surgical approach to the MCP joint.

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Prevention

Although no studies exist with regard to efficacy, most practitioners recommend appropriate buddy taping of the injured finger to an uninjured digit during forceful activities, especially contact sports to help prevent reinjury.

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Prognosis

The prognosis is good for MCP joint injuries that are recognized early and treated appropriately.

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Patient Education

The patient needs to be educated regarding his or her particular injury and the methods of proper treatment to ensure adequate healing. Joint protection is a key concept for the patient to understand. Once healing has taken place through immobilization, the patient should be instructed in a progressive range-of-motion program to regain mobility of the injured joint(s).

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Contributor Information and Disclosures
Author

Matthew Gammons, MD  Assistant Clinical Professor, Department of Family and Community Medicine, Medical College of Wisconsin; Medical Director, Castleton State College; Consulting Staff, Vermont Orthopaedic Clinic and Killington Medical Clinic

Matthew Gammons, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, and American Society of Mechanical Engineers

Disclosure: Nothing to disclose.

Specialty Editor Board

Anthony J Saglimbeni, MD  President, South Bay Sports and Preventive Medicine Associates; Private Practice; Team Internist, San Francisco Giants; Team Internist, West Valley College; Team Physician, Bellarmine College Prep; Team Physician, Presentation High School; Team Physician, Santa Clara University; Consultant, University of San Francisco, Academy of Art University, Skyline College, Foothill College, De Anza College

Anthony J Saglimbeni, MD, is a member of the following medical societies: California Medical Association and Santa Clara County Medical Association

Disclosure: South Bay Sports and Preventive Medicine Associates, Inc Ownership interest Other

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Russell D White, MD  Professor of Medicine, Professor of Orthopedic Surgery, Director of Sports Medicine Fellowship Program, Medical Director, Sports Medicine Center, Head Team Physician, University of Missouri-Kansas City Intercollegiate Athletic Program, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center-Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, and American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD  Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Director of Primary Care Sports Medicine Fellowship, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, David R Steinberg, MD, to the development and writing of this article.

References

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  2. Neviaser RJ. Dislocations and ligamentous injuries of the digits. In: Chapman MW, ed. Operative Orthopaedics. 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1993:1237-50.

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  12. Dinh P, Franklin A, Hutchinson B, Schnall SB, Fassola I. Metacarpophalangeal joint dislocation. J Am Acad Orthop Surg. May 2009;17(5):318-24. [Medline].

  13. Maheshwari R, Sharma H, Duncan RD. Metacarpophalangeal joint dislocation of the thumb in children. J Bone Joint Surg Br. Feb 2007;89(2):227-9. [Medline].

  14. Marcotte AL, Trzeciak MA. Nonoperative treatment for a double dislocation of the thumb metacarpal: a case report. Arch Orthop Trauma Surg. Mar 2008;128(3):281-4. [Medline].

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  16. Peterson JJ, Bancroft LW. Injuries of the fingers and thumb in the athlete. Clin Sports Med. Jul 2006;25(3):527-42, vii-viii. [Medline].

 
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Metacarpophalangeal joint dislocation of the small finger. Posteroanterior radiograph demonstrates loss of joint space.
Metacarpophalangeal joint dislocation of the small finger. Oblique radiograph best demonstrates dorsal dislocation of proximal phalanx.
Metacarpophalangeal joint dislocation of the small finger. Dorsally dislocated proximal phalanx is obscured by other digits. Note that the small finger metacarpal sits palmar to the other metacarpals.
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