II. Epidemiology
- Uncommon Interphalangeal Dislocation
III. Signs
- Deformity of finger in volar angulation at the PIP Joint
-
PIP Central Slip Dislocation
- Inability to extend finger at PIP joint
IV. Imaging
- Check Post-reduction films for Fracture
V. Management
- Reduction
- Use similar method as for Dorsal DIP Dislocation
- Post-reduction (If reduction completed)
- Evaluate for PIP Central Slip Dislocation
- Patient flexes finger at PIP joint to 90 degrees over a table edge, on which the patient's hand rests
- Central Slip injury present if DIP may be extended, but not the PIP joint
- Splint only the PIP in full extension for 6 weeks
- Allows for DIP and MCP range of motion
- Evaluate for PIP Central Slip Dislocation
- Referral Indications
- Early orthopedic Consultation in most cases
- Fracture involves more than 30-40% of intra-articular surface
- Difficult or unsuccessful reduction
- Patient unable to fully extend finger
VI. Complications
- Difficult reduction with often interposed soft tissue
- Usually associated with central slip disruption (avulsion)
- Frequently associated with Boutonniere Deformity
- Prolonged swelling and pain