Imagine being a quarterback on a Division I team and your finger is stuck in a flexed position. You can’t straighten your finger to release the ball. In this case report, doctors present the diagnosis and treatment of a 20-year-old football player with just sush a locked finger joint.
The metacarpophalangeal or MP joint is the large joint that forms what we call the “knuckle” on the back of the hand. A locked MP joint is fairly common in the index and middle fingers. In this case the patient was lifting weights when he felt a “pop” in his index finger. It was painful, and he could no longer extend the finger past 40 degrees. The surgeon was unable to unlock or reduce the joint without doing surgery.
Surgery was done to release the soft tissue around the joint. The joint was put back in place successfully. The first operation didn’t take care of the problem. The patient came back six months later with the same locked MP. A second operation opened the joint. The surgeon found a bony ridge on the joint that was catching a ligament inside the edge of the joint. The bone and ligament were both removed.
Two years later the patient had no symptoms and was able to return to play football as both a quarterback and a wide receiver. The authors present this case to show that not all locking fingers are caused by a single problem. Most patients have a locking MP from a condition called tenosynovitis (inflammation of the tendon sheath). This case was different.