Clinical Case 084: Difficult dislocation

OK Here is a quick case.  One that is a bit outside the norm – not your usual dislocation.

In this case a 14 yo boy presents after falling on the football field.  He landed awkwardly on his hand “popping” his index finger at the knuckle.

On arrival he has an obviously swollen, deformed MCP on the 2nd digit.

A quick X-ray looks like this (click to make the picture bigger!):

Q1:  What is the diagnosis?  Who is it named after?

Q2:  After a quick local block – you pull on the finger – but it aint budging.  Why?

Q3:  What is the most oft described strategy for managing this injury?

Hand MCPdlap

 

handmcdllat

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