Final answer:
Closed reduction is often used for stable fractures like MCP dislocations, but the presence of the volar plate can prevent closed reduction in some cases. Open reduction may be necessary if closed reduction is not possible or fails.
Step-by-step explanation:
Closed reduction and open reduction are two techniques used to treat fractures. Closed reduction involves realigning the fractured bones without surgically opening the skin, while open reduction involves surgically exposing the fracture and directly manipulating the bones into alignment. Closed reduction is typically used for stable fractures that have minimal displacement and can be easily manipulated back into alignment, such as most Metacarpophalangeal (MCP) dislocations.
However, some factors may prevent closed reduction in MCP dislocations. One common structure that can impede closed reduction is the volar plate, a thick ligament-like structure located on the palmar side of the joint. The volar plate can get trapped between the dislocated bones, making it challenging to reduce the dislocation using closed methods alone.
If closed reduction is not possible or fails, open reduction may be necessary. In open reduction, the surgeon makes an incision to directly access the dislocated bones and manipulate them back into place. This allows for more precise reduction and stabilization of the fracture.