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Delayed Presentation of a Locked Metacarpophalangeal Joint Secondary to Incarcerated Sesamoid with Associated Proximal Ulnar Collateral Tear in a 15-Year-Old Boy

Year: 2026

Type: article

Abstract: A 15-year-old right-handed boy presented 7 weeks after a hyperextension injury while playing basketball with a suspected metacarpophalangeal (MCP) joint dislocation to his right thumb and subsequent reduction by his mother at the time of injury. Initial radiographs were negative for acute fracture or dislocation. However, pain and stiffness persisted in the MCP joint, and subsequent magnetic resonance imaging demonstrated an incarcerated radial sesamoid and a proximal ulnar collateral ligament (UCL) injury with migration of the ulnar sesamoid under the proximal UCL, a finding not previously documented in the literature. He underwent surgical excision of the sesamoid bone and repair of the UCL injury with successful improvement in symptoms and return to all activities, including basketball, by his 4-month postoperative visit. This case demonstrates that it is imperative to scrutinize radiographs and consider advanced imaging when evaluating a locked MCP joint following a hyperextension injury.

Source: Journal of Hand Surgery Global Online

DOI: 10.1016/j.jhsg.2026.101026

Authors: Bailey R. Abernathy, Michaela Rasmussen, Andrew Baron

Institutions: Henry Ford Health, Henry Ford Hospital

Language: English

Topic: Orthopedic Surgery and Rehabilitation

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500