Proximal interphalangeal dislocation (finger) - Revision history

Rossdonaldson1: /* Background */

2022-12-14T17:35:08Z

Background

← Older revision		Revision as of 17:35, 14 December 2022
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	[[File:DIP, PIP and MCP joints of hand.jpg\|thumb\|Distal interphalangeal dislocation (DIP), proximal interphalangeal dislocation (PIP), and metacarpophalangeal dislocation (MCP) joints of the finger shown.]]		[[File:DIP, PIP and MCP joints of hand.jpg\|thumb\|Distal interphalangeal dislocation (DIP), proximal interphalangeal dislocation (PIP), and metacarpophalangeal dislocation (MCP) joints of the finger shown.]]
	[[File:Gray337.png\|thumb\|Volar/anterior finger anatomy.]]		[[File:Gray337.png\|thumb\|Volar/anterior finger anatomy.]]
			[[File:Gray338.png\|thumb\|Lateral finger anatomy.]]
	*Most common finger dislocation		*Most common finger dislocation
	*Volar plate ruptures in both dorsal and volar PIP dislocations <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*Volar plate ruptures in both dorsal and volar PIP dislocations <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>

Rossdonaldson1: /* Background */

2022-12-14T16:52:44Z

Background

← Older revision		Revision as of 16:52, 14 December 2022
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	*Volar plate ruptures in both dorsal and volar PIP dislocations <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*Volar plate ruptures in both dorsal and volar PIP dislocations <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	*Lateral dislocations occur when one of collateral ligaments ruptures with at least partial avulsion of volar plate from middle phalanx		*Lateral dislocations occur when one of collateral ligaments ruptures with at least partial avulsion of volar plate from middle phalanx

			{{Hand anatomy}}

	==Clinical Features==		==Clinical Features==

Rossdonaldson1 at 16:48, 14 December 2022

2022-12-14T16:48:11Z

← Older revision		Revision as of 16:48, 14 December 2022
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	==Background==		==Background==
			[[File:DIP, PIP and MCP joints of hand.jpg\|thumb\|Distal interphalangeal dislocation (DIP), proximal interphalangeal dislocation (PIP), and metacarpophalangeal dislocation (MCP) joints of the finger shown.]]
			[[File:Gray337.png\|thumb\|Volar/anterior finger anatomy.]]
	*Most common finger dislocation		*Most common finger dislocation
	*Volar plate ruptures in both dorsal and volar PIP dislocations <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>		*Volar plate ruptures in both dorsal and volar PIP dislocations <ref name="Procedures for orthopedic emergencies">Davenport M. Procedures for orthopedic emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>

Rossdonaldson1: /* Evaluation */

2022-12-14T16:07:35Z

Evaluation

← Older revision		Revision as of 16:07, 14 December 2022
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	==Evaluation==		==Evaluation==
	[[File:Dislocated Finger XRay.png\|thumb\|PIP dislocation of right fifth phalanx]]		[[File:Dislocated Finger XRay.png\|thumb\|PIP posterior dislocation of right fifth phalanx.]]
	*X-ray finger (PA and lateral)		*X-ray finger (PA and lateral)
	**True lateral of only the finger instead of hand will help detect subtle avulsion fractures <ref name="Management of Common Dislocations">Horn A. Management of Common Dislocations. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014. </ref>		**True lateral of only the finger instead of hand will help detect subtle avulsion fractures <ref name="Management of Common Dislocations">Horn A. Management of Common Dislocations. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014. </ref>

Spenceemmett: /* Splinting */

2022-12-02T20:26:28Z

Splinting

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	===[[Splinting]]===		===[[Splinting]]===
	*Stable dorsal reduction: 3wk of immobilization in 20-30 deg of flexion		*Place Alumifoam splint on side of dislocation
			**Stable dorsal reduction: 3wk of immobilization in 20-30 deg of flexion
	**If volar dislocation, may have injury to central slip of the extensor tendons, so must be splinted in full extension for 3 weeks to prevent [[Boutonniere deformity]]		**If volar dislocation, may have injury to central slip of the extensor tendons, so must be splinted in full extension for 3 weeks to prevent [[Boutonniere deformity]]
			**Splint should never extend onto the palm
	*Unstable reduction: Surgery		*Unstable reduction: Surgery
	**Displacement occurs during active range of motion or passive stressing of joint		**Displacement occurs during active range of motion or passive stressing of joint

Rossdonaldson1: /* Clinical Features */

2017-04-28T18:05:58Z

Clinical Features

← Older revision		Revision as of 18:05, 28 April 2017
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	==Clinical Features==		==Clinical Features==
			[[File:Dislocated Finger.jpg\|thumb\|Right fifth PIP phalanx dislocation]]
	*Mechanism: Due to axial load and hyperextension		*Mechanism: Due to axial load and hyperextension
	*Finger pain/deformity		*Finger pain/deformity

Rossdonaldson1: /* Evaluation */

2017-04-28T17:46:54Z

Evaluation

← Older revision		Revision as of 17:46, 28 April 2017
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	==Evaluation==		==Evaluation==
			[[File:Dislocated Finger XRay.png\|thumb\|PIP dislocation of right fifth phalanx]]
	*X-ray finger (PA and lateral)		*X-ray finger (PA and lateral)
	**True lateral of only the finger instead of hand will help detect subtle avulsion fractures <ref name="Management of Common Dislocations">Horn A. Management of Common Dislocations. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014. </ref>		**True lateral of only the finger instead of hand will help detect subtle avulsion fractures <ref name="Management of Common Dislocations">Horn A. Management of Common Dislocations. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014. </ref>

Rossdonaldson1: /* Differential Diagnosis */

2017-04-28T17:43:06Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Hand and finger dislocation types}}		{{Hand and finger dislocation types}}

			{{Hand and finger injury DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1 at 17:38, 28 April 2017

2017-04-28T17:38:45Z

← Older revision		Revision as of 17:38, 28 April 2017
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	*Finger pain/deformity		*Finger pain/deformity
	*Evaluate for extension into joint as open dislocations are common		*Evaluate for extension into joint as open dislocations are common


	==Differential Diagnosis==		==Differential Diagnosis==
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	*X-ray finger (PA and lateral)		*X-ray finger (PA and lateral)
	**True lateral of only the finger instead of hand will help detect subtle avulsion fractures <ref name="Management of Common Dislocations">Horn A. Management of Common Dislocations. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014. </ref>		**True lateral of only the finger instead of hand will help detect subtle avulsion fractures <ref name="Management of Common Dislocations">Horn A. Management of Common Dislocations. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014. </ref>


	==Management==		==Management==

Rossdonaldson1: /* Disposition */

2017-04-28T17:38:12Z

Disposition

← Older revision		Revision as of 17:38, 28 April 2017
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	==Disposition==		==Disposition==
	*Outpatient		*Outpatient
	**If ~~reduction~~, follow up within two weeks with hand specialist		**If reduced, with follow up within two weeks with hand specialist


	==See Also==		==See Also==