A CLINICAL STUDY ON LIMITED DORSAL APPROACH FOR OPEN REDUCTION OF KAPLAN'S DISLOCATION (DORSAL DISLOCATION OF METACARPOPHALANGEAL JOINT OF INDEX FINGER)

BACKGROUNDDislocation of Metacarpophalangeal (MCP) joint of index linger is an uncommon injury encountered in Orthopaedic practice.Closed reduction is commonly attempted and in cases of irreducibility open reduction by volar approach is used as described by Kaplan.In the present study, a dorsal approach is used in a series of patients which has many advantages.Aim-To describe and use limited dorsal approach in the management of irreducible dorsal dislocation of Metacarpophalangeal joint. MATERIALS AND METHODS45 patients between the ages of 8 and 45 with irreducible dorsal dislocation of Metacarpophalangeal joint were included for the study and a minimal dorsal approach performed in reducing the dislocation. RESULTS30 patients had a good recovery of joint function and incidence of joint stiffness noted in 5 patients.2 patients lost for followup and two patients developed Osteonecrosis of the metacarpal head. 2 patients developed premature closure of the physis. CONCLUSIONDorsal dislocation of Metacarpophalangeal joint of index finger (Kaplan's dislocation) which is irreducible by closed manipulation is best approached dorsally and limited dorsal approach by simple stab incision is enough in most of the cases.