Interphalangeal Dislocation

Aka: Interphalangeal Dislocation, IP Dislocation, IP Joint Dislocation, Finger Dislocation at Interphalangeal Joint, Interphalangeal Joint Dislocation

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II. Types

  1. Dorsal PIP Dislocation
  2. Lateral PIP Dislocation
  3. Volar PIP Dislocation
  4. DIP Dislocation
  5. IP Joint Dislocation at Thumb
  6. Metacarpal-Phalangeal Dislocation

III. Mechanism

  1. Hyperextension injury most common
  2. Common injury in athletes

IV. Complications

  1. Longterm stiffness
  2. Phalanx Fracture
  3. Tendon Injury

V. Exam

  1. Ligament stability
  2. Motor function
  3. Sensation
  4. Distal circulation (Capillary Refill)
  5. Active joint range of motion
    1. Flexion
    2. Extension
  6. Finger alignment
    1. Extension
    2. Flexion
      1. Finger tips should not overlap
      2. Finger tips should all point towards thenar eminence

VI. Signs

  1. Grossly deformed digit
  2. Swelling
  3. Erythema
  4. Decreased range of motion
  5. Tenderness to palpation

VII. Imaging: Three View Finger XRay before and after reduction

  1. Exclude avulsion Fracture
  2. Reduction may be attempted on sideline without XRay

VIII. Management

  1. See Dorsal PIP Dislocation (most common, hyperextension injury)
  2. See Lateral PIP Dislocation
  3. See Volar PIP Dislocation
  4. See DIP Dislocation
  5. See IP Joint Dislocation at Thumb
  6. See Metacarpal-Phalangeal Dislocation

IX. References

  1. Borchers (2012) Am Fam Physician 85(8): 805-10 [PubMed]
  2. Leggit (2006) Am Fam Physician 73(5): 827-34 [PubMed]
  3. Oetgen (2008) Curr Rev Musculoskelet Med 1(2):97-102 [PubMed]

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