title: Simultaneous open and Closed Dislocation of four Metacarpophalangeal Joints: A Case Report and Review of Literature.
abstract: BACKGROUND
  Multiple simultaneous dislocations of the metacarpophalangeal joints are exceedingly rare. Five cases only were described in the English literature. Only one case necessitated open reduction. A case of simultaneous open and closed dislocation of ipsilateral four metacarpophalangeal joints is presented. The case had a delayed presentation (8 days following the trauma) and needed open reduction.
  
  
  METHODS
  A 33-year-old manual worker sustained dislocation of the ulnar four metacarpophalangeal joints of his non dominant hand. The hand injury was missed for eight days. The injury was successfully managed by open reduction. The patient regained near normal functional outcome.
  
  
  CONCLUSIONS
  Open reduction may be needed for these injuries. Prompt intervention and early rehabilitation are needed for satisfactory outcome.
authors.affiliation: Department of Orthopedic, Ain Shams University, Abbasia Square Cairo-Egypt.
authors.forename: Ahmed Naeem
authors.initials: AN
authors.lastname: Atiyya
authors.affiliation: Department of Orthopedic, Ain Shams University, Abbasia Square Cairo-Egypt.
authors.forename: Ramy Ahmed
authors.initials: RA
authors.lastname: Soliman
keywords: irreducible; multiple MP dislocations; volar approach