Summary
A 79-year-old man sustained left open metacarpophalangeal joints III–V dislocation injury in the dorsal direction associated with avulsions of the volar fibrocartilaginous plates. Surgical revision became necessary. Three months after the injury, the patient was very satisfied with his intermedium outcome; however, complete restoration of hand function was not observed at this time. To our knowledge, this is the first case presentation in the literature that describes such an injury involving the metacarpophalangeal joints III–V.
The ReMotion total wrist is one 3rd generation implant which is current in use. Mid-to long-term outcomes regarding its survivorship revealed satisfying results. However, this implant has a design-related issue resulting in development of painful radial-side impingement. We present two cases involving two modified implantation techniques ((1) complete removal of scaphoid accompanied by partial cement augmentation of the radial-side fixation screw for carpal component, and (2) positioning of both fixation screws for carpal component into the scaphoid adjacent to the capitate peg without crossing the carpometacarpal joins) which could be able to avoid this specific complication. However, such an "off label" use in the absence of a larger number of patients and further biomechanical investigations can only be used in single cases currently.
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