Locked thumb metacarpophalangeal joint due to sesamoid bone entrapment: A case report and review of literature

Locked thumb metacarpophalangeal (MCP) joint has been known as a relatively rare condition. We present a case of a 25-year-old male presented with a traumatic locked thumb MCP joint of the right hand. Clinical presentation showed the joint was in a hyperextention position and resistant to active flexion and extension. The radial sesamoid was distally displaced on X-ray film and entrapped into the joint on CT scan. The mechanism of the locked MCP joint was thought as a “pull-hook lock” between the pointed proximal edge of the sesamoid and the deformed volar groove on the cartilaginous surface of the metacarpal head. Surgical treatment included partially releasing the insertion of the abductor pollicis brevis (APB) and flexor pollicis brevis (FPB) muscles to move the entrapped radial sesamoid, and resurfacing the deformed metacarpal head.