Management of Proximal Interphalangeal Joint Fracture Dislocations

Hand Clin. 2018 May;34(2):149-165. doi: 10.1016/j.hcl.2017.12.005.

Abstract

Fracture dislocations of the proximal interphalangeal (PIP) joint of the finger are often caused by axial load applied to a flexed joint. The most common injury pattern is a dorsal fracture dislocation with a volar lip fracture of the middle phalanx. Damage to the soft-tissue stabilizers of the PIP joint contributes to the deformity seen with these fracture patterns. Unfortunately, these injuries are commonly written off and left untreated. A late-presenting PIP joint fracture dislocation has a poor chance of regaining normal range of motion. The provider must be suspicious of these injuries. Treatment options and algorithm are reviewed.

Keywords: Dynamic external fixator; Fracture-dislocation; Hemihamate arthroplasty; Proximal interphalangeal joint; Volar plate arthroplasty.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Arthroplasty / methods
  • Athletic Tape
  • Autografts
  • Closed Fracture Reduction
  • External Fixators
  • Finger Injuries / diagnosis
  • Finger Injuries / therapy*
  • Finger Joint / anatomy & histology
  • Finger Joint / diagnostic imaging
  • Finger Joint / surgery*
  • Fracture Dislocation / classification
  • Fracture Dislocation / diagnosis
  • Fracture Dislocation / therapy*
  • Fracture Fixation, Internal
  • Hamate Bone / transplantation
  • Humans
  • Open Fracture Reduction
  • Splints