A case of unusual displacement in a finger, with an avulsion fragment from the dorsal metacarpal head of the finger displaced in the palmar direction under the volar plate is described. An 18-year-old woman presented with complaint of difficulty flexing the metacarpophalangeal (MP) joint of the right little finger after a fall onto the outstretched hand. Three-dimensional computed tomography (CT) was useful for diagnosing this condition. Use of both palmar and dorsal approaches was needed to reduce the displacement and to fix the bones with a single screw. Bone union was achieved, and the patient has been asymptomatic for more than 10 months.
BischoffRBuechlerUDe RocheRJupiterJ. Clinical results of tension band fixation of avulsion fractures of the hand. J Hand Surg1994;19A:1019–26
2.
CarterCWilkinsonJ. Persistent joint laxity and congenital dislocation of the hip. J Bone Jt Surg1964;46B:40–5.
3.
FultzCWBuchananJR. Complex fracture-dislocation of the metacarpophalangeal joint. Case report. Clin Orthop Relat Res1988;227:255–60.
4.
GeeTCPhoRW. Avulsion-fracture at the proximal attachment of the radial collateral ligament of the fifth metacarpophalangeal joint—a case report. J Hand Surg1982;7A:526–7.
5.
KuhnKMDaoKDShinAY. Volar A1 pulley approach for fixation of avulsion fractures of the base of the proximal phalanx. J Hand Surg2001;26A:762–71.
6.
SakumaMNakamuraRInoueGHoriiE. Avulsion fracture of the metacarpophalangeal joint of the finger. J Hand Surg1997;22B:667–71.
7.
SawantNKulikovYGiddinsGE. Outcome following conservative treatment of metacarpophalangeal collateral ligament avulsion fractures of the finger. J Hand Surg2007;32B:102–4.
8.
ShewringDJThomasRH. Collateral ligament avulsion fractures from the heads of the metacarpals of the fingers. J Hand Surg2006;31B:537–41.
9.
ViegasSFHeareTCCalhounJH. Complex fracture-dislocation of a fifth metacarpophalangeal joint: case report and literature review. J Trauma1989;29:521–4.
