Treatment of Dislocated Metacarpophalangeal (MP) Joint of the Thumb

Diagnostic Assessment

• Radiographic assessment with at least 2 views (PA and lateral) is essential to evaluate fracture displacement and articular involvement 1

Treatment Algorithm

• Immobilization with thumb spica cast or splint for 3-6 weeks following reduction 1
• Surgical intervention is indicated when fracture fragment displacement >3mm is present 1
• Surgical intervention is indicated when more than one-third of the articular surface is involved 1

Post-Treatment Management

• Immobilization with thumb spica cast or splint for 3-6 weeks following reduction 1
• Follow-up should monitor pain relief and restoration of function 1

Important Considerations

• For thumb base osteoarthritis, orthoses should be considered for symptom relief with long-term use advocated 2
• Surgery (e.g., interposition arthroplasty, osteotomy, arthrodesis) should be considered for severe thumb base OA when conservative treatments have failed 3, 4