Proximal Interphalangeal Joint Dislocation

Aka: Proximal Interphalangeal Joint Dislocation, PIP Dislocation, Dislocation at Proximal Interphalangeal Joint

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II. Epidemiology

  1. PIP Joint is the most commonly dislocated finger joint

III. Mechanism

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

IV. Types

  1. Dorsal PIP Dislocation
  2. Lateral PIP Dislocation
  3. Volar PIP Dislocation

V. Complications

  1. General
    1. Risk of longterm stiffness
    2. Distal Phalanx Fracture
    3. Tendon Injury
  2. Dorsal PIP Dislocation (most common)
    1. Risk of Volar Plate Injury
  3. Volar PIP Dislocation (rare)
    1. Risk of Central slip rupture
    2. May result in Boutonniere Deformity

VI. Imaging: Finger XRay before and after reduction

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

VII. Signs

  1. Grossly deformed digit

VIII. Management

  1. See Dorsal PIP Dislocation
  2. See Lateral PIP Dislocation
  3. See Volar PIP 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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