Proximal interphalangeal joint dislocation - 4th finger

Case contributed by Leonardo Lustosa

Presentation

Fall onto the hand. Deformity of the 4th finger upon physical examination (see photographs below).

Patient Data

Age: 50 years
Gender: Female

Radiographs confirmed the dorsal dislocation of the proximal interphalangeal joint (PIPJ) of the 4th finger. The dislocation can be classified as a type I dorsal dislocation (hyperextension).

No fractures are seen.

Radiographs performed after the closed reduction revealed an adequate reduction of the PIPJ. No fractures are seen.

Photographs show the aspect of the finger on presentation and post the successful reduction of the dislocated finger.

Case Discussion

Dorsal proximal interphalangeal joint dislocations are usually the result of a hyperextension mechanism.

Plain radiographs are often sufficient to diagnose a PIPJ dislocation, but it is important to study the digit with proper frontal and lateral radiographs, which unfortunately were not performed in this case. Hand radiographs alone may miss more subtle fractures and/or dislocations of a digit, such as a volar plate avulsion fracture, which was not present in this case.

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