Triple joint injuries of the same digit.
This article presents a rare case of simultaneous triple joint injuries in the same digit. A 54-year-old, right-handed man sustained simultaneous triple joint injuries in a digit, composed of a fracture of the dorsal base of the distal phalanx involving one-third of the phalanx, dorsal dislocation of the proximal interphalangeal joint with a volar plate fracture, and ulnal dislocation of the metacarpophalangeal joint. Surgery was performed on the patient. Two years postoperatively, active range of motion of the distal interphalangeal joint improved from 0 degrees to 40 degrees, of the proximal interphalangeal joint improved from -20 degrees to 100 degrees, and of the metacarpophalangeal joint improved from 5 degrees to 90 degrees. Grip strength was 32 kg compared to 35 kg on the nonaffected side. No ligamentous laxity was demonstrated in the finger joints. A fracture involving one-third of the phalanx may be caused by forced hyperextension of that joint. This hyperextension may result in a tear of the volar plate of the proximal interphalangeal joint, leading to a dislocation at that joint. This continuous force directs the metacarpophalangeal joint in a slight ulnal shift, and may result in rupture of the medial collateral ligament in the metacarpophalangeal joint. To our knowledge, this injury has not been reported in the literature.
Morohashi
Akira
A
Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.
Takase
Katsumi
K
D005383:Finger Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome