[Complex fracture-dislocation of the proximal interphalangeal joint. A case report and focus on palmar proximal interphalangeal fractures-dislocations]

A Review on Volar Fracture-Dislocations of the Proximal Interphalangeal Joint

Volar fracture-dislocations of the proximal interphalangeal joint are rare injuries caused by an axial force on a flexed digit resulting in an avulsion fracture of the dorsal lip of the middle phalanx with volar dislocation of the joint. This volar subtype is analogous to the more common dorsal subtype with a mirror image fracture on the dorsal lip of the middle phalanx. The main significance in this type of injury lies in the disruption of the extensor mechanism at the central slip. The goals of treatment, apart from restoring a congruent and stable joint, is to restore the extensor mechanism to prevent a boutonnière deformity. In this article, we summarise the current literature and discuss the principles for treatment of this uncommon injury. Level of Evidence: Level V (Therapeutic).

Volar fracture-dislocation of the proximal interphalangeal joint: Four cases at an average follow-up of 3 years

Volar dislocation of the proximal interphalangeal joint associated with dorsal fracture of the base of the middle phalanx is a rare injury, with only 38 cases published. We report here four such cases: three treated surgically and one conservatively. Patients had a mean age of 19.5 years. At an average follow-up of 3 years, pulp-to-palm contact was obtained and no pain was reported with regular daily activities. All patients considered themselves cured and were very satisfied with the result. Incomplete reduction of the dorsal fragment or the presence of localized articular impaction warrant surgical treatment.