Complex metacarpophalangeal joint dislocations management with dorsal extensor sparing approach

Metacarpophalangeal (MCP) joint dislocations, though rare, pose unique challenges in their management. Surgical intervention is typically necessary for complex cases, with both volar and dorsal approaches available, each with distinct advantages and disadvantages. This article presents a case series involving three patients with acute complex MCP dislocations, successfully treated using the dorsal extensor reflecting technique. This approach involves a dorsal incision, extensor mechanism reflection, and manipulation of the volar plate to achieve reduction. The study underscores the rarity of MCP dislocations, the role of the volar plate in these injuries, and the various surgical options. Notably, the dorsal approach is highlighted for its simplicity, reduced risk to neurovascular structures, and efficient intraoperative execution. This approach could be a preferred choice for acute complex MCP dislocations due to its shorter learning curve and straightforward implementation. The article underscores the need for further comparative studies with larger sample sizes to validate the efficacy of the dorsal approach. In conclusion, the dorsal extensor reflecting technique proves to be a valuable approach for managing acute complex MCP joint dislocations, offering a promising alternative to other surgical methods.