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Journal of the Korean Society for Surgery of the Hand 2011;16(3):149-153.
Published online September 30, 2011.
Open Reduction Through the Modified Volar Approach in Complex Dorsal Dislocations of the Metacarpophalangeal Joint
Soo Joong Choi, Bong Cheol Kwon, Yong Beom Lee, Won Hyoung Shin
Department of Orthopedic Surgery, Hallym University Sacred Heart, Hallyrn University School of Medicine, Korea. csjwillow@yahoo.co.kr
Received: 31 March 2011   • Revised: 15 August 2011   • Accepted: 24 August 2011
Abstract
Purpose
To describe the surgical treatment of the complex dorsal metacarpophalangeal dislocations and its results, emphasizing on the modified volar approach with A1 pulley release. MATERIALS AND METHODS: We experienced 6 cases of dorsal dislocation of the metacarpophalangeal joint. We performed open reduction with the modified volar approach described by Eaton and Dray. Postoperatively posteroanterior and lateral radiographs of the index finger metacarpophalangeal joint and metacarpophalangeal joint range of motion was followed.

Results
One case with a large osteochondral fracture was operated with volar and doral approach both. Overall end results were good without any significant restriction of motion and stability of the fingers.

Conclusion
Modified volar approach with A1 pulley release is an excellent method for complex dorsal metacarpophalangeal dislocations without osteochondral fracture.
 
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