Proximal interphalangeal dislocation (finger)

Background

• Common; due to axial load and hyperextension
• Dorsal dislocation occurs when volar plate ruptures
• Lateral dislocations occur when one of collateral ligaments ruptures w/ at least partial avulsion of volar plate from middle phalanx

Differential Diagnosis

Hand and finger dislocations

• Finger dislocations
  • Distal interphalangeal dislocation (finger) (DIP)
  • Proximal interphalangeal dislocation (finger) (PIP)
  • Metacarpophalangeal dislocation (finger) (MCP)
• Thumb dislocations
  • Interphalangeal dislocation (thumb) (IP)
  • Metacarpophalangeal dislocation (thumb) (MCP)
• Hand dislocations
  • Carpometacarpal dislocation

Management

Reduction

• Same as for DIP joint

Splinting

• Stable Reduction: 3wk of immobilization in 20-30 deg of flexion
• Unstable reduction: Surgery
  • Displacement occurs during active range of motion
  • Displacement occurs during passive stressing of joint
  • >20 deg of deformity and instability with lateral testing

See Also

• Hand and finger dislocations