Locked metacarpo-phalangeal joint of the thumb

16 patients developed locking of the M.P. joint of the thumb as the result of a hyperextension injury. Four were successfully treated by manipulation under an intra-articular injection of a local anaesthetic, while the remaining twelve required open reduction. All were examined 4 to 48 months after treatment (average 12 months). The torn palmar plate and the accessory collateral ligament, which acted as a constrictive band, were trapped on the prominence of the radial condyle of the metacarpal. Four of the twelve surgically-treated patients had a deformity which we believe was congential: a transverse groove over the radial condyle of the metacarpal. No patients had a recurrence of the locked joint.     

Dorsal fracture subluxation of the distal interphalangeal joint of the finger and the interphalangeal joint of the thumb treated by extension block splintage.

In a prospective study six patients with dorsal fracture subluxation of the IP joint of the thumb or the DIP joint of the finger were treated conservatively using an extension block splint. The fracture size varied from 22% to 47% of the articular surface of the volar base of the terminal phalanx. Good or excellent results were reported in all cases except for one, which was fair. Only one case in the study complained of any pain, and this was minimal. Conservative treatment using extension block splintage for this injury is as good as a surgical approach.     

Treatment of thumb metacarpophalangeal and interphalangeal joint arthritis

Degenerative joint disease affecting the thumb metacarpophalangeal and interphalangeal joints is a debilitating condition, which can significantly restrict activities of daily living. Conservative measures to address symptoms include oral anti-inflammatory medications, activity modification and splinting, and intraarticular corticosteroid injections. Surgical interventions include arthroscopic synovectomy, arthroplasty, and finally arthrodesis of the affected articulations. Although short-term results from synovectomy and arthroplasty seem promising, long-term data are not yet available. Arthrodesis of the metacarpophalangeal and interphalangeal joints yields a stable yet functional thumb with reliably good pain relief.     

Combined reconstruction of volar and radial instability of a thumb metacarpo-phalangeal joint

The purpose of this paper is to present a case of the combined volar and radial ligament instability of a thumb metacarpophalangeal joint secondary to trauma. A successful reconstruction of the volar capsule and the radial collateral ligament was achieved using the tendon of the extensor pollicis brevis.     

The sesamoids of the metacarpo-phalangeal joint of the thumb: an anatomical and clinical study

Two unusual cases of injury to the sesamoids of the M.P. joint of the thumb are described. An anatomical dissection of the M.P. volar plate region, including the sesamoids, was undertaken to delineate the details of the sesamoids' relationship to the M.P. joint, flexor tendon, flexor tendon sheath and capsule of the joint. Histological studies were carried out to demonstrate a tendinous extension of the muscles that attach to the sesamoids.     

Arthrodesis of the metacarpo-phalangeal joint of the thumb: a review of 42 cases

42 arthrodeses of the metacarpo-phalangeal joint of the thumb in 34 patients have been reviewed at a mean of 22.5 months after operation. Where bone stock allowed, Omer's chevron arthrodesis was used. 83% of these operations were judged to have been successful by our patients, most of whom were suffering from inflammatory joint disease. Some patients had very poor pinch pressures when reviewed, but only those with persistent instability or pain were disappointed. All arthrodeses were fixed in flexion; although the angle varied, no ideal position was identified.     

The adipofascial turnover flap for coverage of the exposed distal interphalangeal joint of the fingers and interphalangeal joint of the thumb

The adipofascial turnover flap was used to cover exposed distal interphalangeal joints of 8 fingers and interphalangeal joints of 4 thumbs. The flap was raised from the dorsum of the injured digit with a base located at the edge of the defect. The flap has a random type of vascularity and was designed with a base-to-length ratio of 1:1.5 to 1:2. All flaps survived completely. Various other types of flaps that have been used to reconstruct dorsal digital skin defects were reviewed and compared with the adipofascial turnover flap.     

Simultaneous dislocation of the interphalangeal joint of the thumb and the carpal lunate

A dislocation of the interphalangeal joint of a thumb was treated without problems. The simultaneous dislocation of the lunate was not diagnosed or treated until the plaster cast was removed. Even in cases with an obvious lesion like a finger joint dislocation it is necessary to investigate all other fingers and the wrist to exclude other lesions and to avoid delay in treatment.     

Two cases of closed dislocation of the interphalangeal joint of the thumb

Dorsal dislocation of the interphalangeal (IP) joint of the thumb is a rare injury, and closed dislocation without fracture is especially unusual. We present here two cases of closed dislocation of the thumb which were reduced by manipulation.     

Childhood Dupuytren’s disease of the interphalangeal joint of the thumb

To date, there are only 13 cases of Dupuytren’s disease documented in the English literature in children less than 13 years and only seven cases histologically diagnosed in those under 10 years. We present a rare case of childhood Dupuytren’s contracture involving only the interphalangeal joint of the thumb and review of current literature of the preferred management of Dupuytren’s disease in childhood.     

Rupture of the ulnar collateral ligament of the metacarpo-phalangeal joint of the thumb: clinical considerations

The authors report 40 cases of lesions of the ulnar part of the first metacarpo-phalangeal joint. In their experience only the main collateral ligament's lesions (alone or associated) need a surgical treatment. Only a correct diagnosis and early treatment lead to a complete functional recovery.     

The range of motion of the metacarpo-phalangeal joint of the thumb and its relationship to injury.

A wide variation in the range of flexion of the metacarpo-phalangeal joint of the thumb in normal individuals is described. Patients with a poor range of flexion at this joint have a significantly higher incidence of indirect soft-tissue injury to the joint.     

Pinching of the single sesamoid bone of the thumb into the metacarpo-phalangeal joint without luxation]

Authors demonstrate the extremely rare case of articular pinching of the single and not well-developed sesam bone at the metacarpophalangeal joint on over extension without luxation and associated injuries. After reviewing the history and pathology it is described that this alteration can be treated with voluntary muscle function and without operation too.     

Distal avulsion of the palmar plate of the interphalangeal joint of the thumb

A 63-year-old woman was unable to actively flex the interphalangeal joint of her right thumb after a hyperextension injury. Surgical exploration revealed an avulsion of the distal insertion of the palmar plate, allowing the bulk of the plate to block the joint during attempted active flexion. Resection of the palmar plate restored active flexion and caused no joint instability. We do not believe this lesion, which resulted in this disability, has been previously described.