The finger MCP joints are condyloid joints allowing flexion-extension and abduction-adduction. Their collateral ligaments tighten in flexion (the cam-shaped metacarpal head increases the effective moment arm in flexion) — MCP joint immobilisation in extension leads to contracture. Safe position immobilisation (MCP in 70-90 degrees flexion, IP in full extension) maintains collateral ligament length.
MCP joint arthroplasty (Swanson silicone implant or surface replacement) for rheumatoid arthritis restores finger alignment and function. The intrinsic-plus deformity of RA (MCP flexion with IP extension from intrinsic tightening) produces the characteristic ulnar drift from radial collateral ligament attenuation.
Finger MCP dorsal dislocation from hyperextension reducing closed under sedation — open reduction required for complex irreducible dislocations trapped by the volar plate.
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