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Category: Volume 05 Issue 12 December 2017
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Title: 2nd Metacarpophalangeal Joint Fracture Dislocation [Kaplan’s Lesion] Operated by open Reduction with Dorsal Approach: A Case Report

Authors: Dr Bhargav Desai, Dr Ajay Trivedi, Dr Rameez Musa, Dr Prarthan Amin

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.35

Abstract

The rare complex dislocation of metacarpophalyngeal joint, also called Kaplan’s lesion requires open reduction. In this dislocation, head of metacarpal is buttonholed within the various anatomical structures like capsulo- ligamentous attachments around the joint preventing closed reduction. Here we have dealt with the issue with the dorsal approach rather than the volar one as the former has the advantage of reduced neurovascular compromise and direct exposure of fibrocartilagenous volar plate blocking the reduction otherwise. After relocating the volar plate and k wire fixation of the metacarpal head, splinting done in early postoperative period with sequential removal of k-wires later and physiotherapy started.  We suggest dorsal approach in view of better visualization, negligible injury to neurovascular bundle and better fixation of associated fracture.

Keywords: Kaplan’s lesion, open reduction, dorsal approach, fibrocartilagenous volar plate.

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Corresponding Author

Dr Bhargav Desai