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Treatment of Post-traumatic Dislocation of Metacarpophalangeal Joints of the Hand
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Seung Koo Rhee, Seok Whan Song, Joo Yup Lee, Chang Youn Moon, Jae Chan Oh
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J Korean Soc Fract 2003;16(2):253-261. Published online April 30, 2003
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DOI: https://doi.org/10.12671/jksf.2003.16.2.253
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 Abstract
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- PURPOSE
To analyse the obstacles to prevent the reduction for dislocation of the metacarpophalangeal (MP) joints of the hand and evaluate the relationship between the sex and dislocation type in closed reduction case.
MATERIALS AND METHODS
Total 27 cases of MP joint dislocation of the hand (11 cases of thumb, and 14 index and 2 little finger) were reviewed retrospectively. The anatomical structures to prevent the reduction were confirmed at operation and the cases which were reduced immediately were also analysed for their ages and differences of damaged structures, and finally their complications or outcome were reviewed for average 7 months after reduction.
RESULTS
In 11 cases of thumb MP joint dislocations, the complex dorsal dislocations in which the protruded metacarpal neck was caught by buttonhole of torn anterior joint capsule, volar plate and FPB were reduced by open method in 8 cases, and closed reduction was done in 2 cases but one old case required arthrodesis. In other finger MP joint dislocations, the Kaplan's concept to prevent the reduction was confirmed. But reduction of torn volar plate and incision of transverse metacarpal ligament were sufficient to reduce the dislocation with gentle longitudinal traction during the operation. In two cases of little finger MP joint dislocation, the ruptured radial collateral ligaments were noted after open reduction and it must the repaired to prevent the finger instability later. Their overall end results were good without any significant restriction of MP joints motions and finger instabilities.
CONCLUSION
One or two times of closed reduction with proper local anesthesia could be tried, but simple reducible dislocation can be converted to complex irreducible ones by the inappropriate traction method, and so proper reduction technique by closed or even in open way is important with the knowledge of anatomical obstacles to prevent the reduction of the metacarpophalangeal joints.
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Treatment of Pertrochanteric Fracture with Femoral Neck Fracture
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Weon Yoo Kim, Chang Whan Han, Woo Sung Choi, Jong Hoon Ji, Chang Youn Moon, Jin Young Kim
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J Korean Soc Fract 2002;15(3):307-311. Published online July 31, 2002
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DOI: https://doi.org/10.12671/jksf.2002.15.3.307
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Abstract
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- OBJECTIVES
To establish the precise diagnosis of a comminuted pertrochanteric fracture with femoral neck fracture in a senile osteoporotic patient and report of a preliminary clinical results of early bipolar hemiarthroplasty.
MATERIAL & METHODS: Consecutive seven cases of comminuted pertrochanteric fractures who were suspicious to have combination with femoral neck fracture were evaluated. All cases had routine radiographs and CT scans of proximal femur and performed with bipolar hemiarthroplasties. Observation of the retrieved femoral head to evaluate a fracture and recorded with photograph. Postoperative evaluation was done with Daubine & Postel clinical grading with medical recording and personal telephone. The clinical evaluation was focused on the recovery for preinjured walking distance.
RESULTS
All patients were proved to have combination with pertrochanteric fractures and femoral neck fractures. In addition, all patients were recovered to more than good in clinical grading and pre-injured walking distance.
CONCLUSION
To make a precise diagnosis of pertrochanteric fractures with femoral neck fracture it is recommended to perform the CT scan with prompt reading of the simple radiographs in suspicious case. An early bipolar hemiarthroplasty was also recommended to treat this kind of senile difficult fracture.
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