Proximal interphalangeal joint dislocations and fracture-dislocations

Abstract

Although proximal interphalangeal joint dislocations are generally straightforward to treat, fracture-dislocations are among the most difficult hand injuries to manage. Fracture patterns range from simple to treat palmar plate avulsion fractures to complex, unstable pilon fractures of the base of the middle phalanx, where achieving adequate reduction and fixation can be extremely difficult. Moreover, these fractures may present sub-acutely or chronically, which greatly adds to the complexity of the case. It is therefore no surprise that clinical results vary and are often difficult to predict. We will discuss the clinical presentations, the various dislocation and fracture-dislocation patterns, treatment options and the complications of these injuries.

Neglected Dorsal Proximal Interphalangeal Joint Dislocation Treated by Volar Plate Arthroplasty: A Case Series

“…Assessment of articular fractures of fingers of the hand with respect to size of fracture fragments, associated wound if any, stability of the joint, and underlying capsular or volar plate damage is very much important while planning the management. Treatment options range from ligamentotaxis with mini external fixators [6] or Joshi External Stabilizing System (JESS), Suzuki frame [7] assembly to simple k-wire fixations [8], trans-osseous fixation [9] and 1.5 to 2.0 mm fragment fixation systems [6]. If there is no associated dislocation of the PIP joint, it can be managed with closed methods and preferably using the principle of ligamentotaxis [10].…”