![]() Dorsolateral dislocation of the proximal interphalangeal joint: closed reduction and early active motion or static splinting a retrospective study. ![]() Proximal interphalangeal joint fracture dislocations. Fracture dislocations of the proximal interphalangeal joint. Delee and Drez's Orthopaedic Sports Medicine: Principles and Practice. Fractures, dislocations, and thumb injuries. New York, NY: Oxford University Press 2010:181. Oxford American Handbook of Sports Medicine. In: Bytomski JR, Moorman CT, MacAuley D, eds. Non-operative treatment of common finger injuries. Epidemiology of US high school sports-related fractures, 2005–2009. Swenson DM, Yard EE, Collins CL, Fields SK, Comstock RD. The epidemiology of acute sports-related fractures in adults. Referral recommended (possible flexor digitorum profundus retraction)Ĭourt-Brown CM, Wood AM, Aitken S. ![]() Radiographs show a bony fragment at volar surface of the proximal distal phalanx Splint DIP joint in extension for eight weeksĬonservative treatment is ineffective large displaced bony fragment or significant volar subluxationįlexor digitorum profundus avulsion fractureĪssess for inability to flex at the DIP joint Radiographs show a bony fragment at dorsal surface of the proximal distal phalanx Splint for two to four weeks followed by range of motion hyperesthesia, pain, and numbness common for up to six months following injuryĪssess for inability to extend at DIP joint Reductions requiring anesthesia, open reductions Splint and early range of motion for simple dislocations Obtain postreduction radiographs (soft tissue injuries often impede reduction) MCP dislocation (especially in the thumb)Ĭheck for neurovascular status and soft tissue injuries Volar: Splint in extension if there is an associated central slipįractures involving greater than 30 to 40 percent of the intra-articular surface, reduction is difficult or unsuccessful, the patient is unable to obtain full extension following reduction Identify direction (dorsal, volar, lateral)Ĭheck for neurovascular status and soft tissue injuries (volar plate in dorsal dislocation, central slip in volar dislocation) Referral to a hand specialist is required if a fracture is unstable, involves a large portion (greater than 30 percent) of the intra-articular surface, or has significant rotation. Some common finger fractures can be treated conservatively with appropriate reduction and immobilization. Referral to a hand specialist is needed if a dislocation cannot be reduced is unstable following reduction or involves significant ligament, tendon, or soft tissue injury. ![]() Finger dislocations should be reduced as quickly as possible and concurrent soft tissue injuries treated appropriately. Dorsal dislocation of the proximal interphalangeal joint is the most common type of finger dislocation. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of finger fractures and dislocations. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Finger fractures and dislocations are common injuries that are often managed by family physicians.
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