Introduction The most commonly diagnosed finger dislocation is a dorsal dislocation of the PIP joint.
The most commonly diagnosed finger dislocation is a dorsal dislocation of the PIP joint. There are three types of PIP joint dislocation which are volar, dorsal, and lateral dislocation. The PIP joint is includes the proximal and middle phalanx and is supported by multiple soft tissue structures.
These include the collateral ligament, central slip of the extensor tendon, flexor tendon sheath, and also the volar plate. The volar plate is a fibrocartilaginous structure that is located on the palmar surface connecting the proximal to the middle phalanx. Proper relocation of a dislocated PIP is important because a neglected or improperly treated PIP dislocation can lead to joint contracture and figure stiffness.
Case Vignette A 17 year old high school soccer play fell and notice their middle finger was dislocated dorsally. They are diagnosed with a dorsal dislocation of the proximal interphalangeal joint. Which structure can be damaged with a dorsal PIP dislocation?
A) Volar plate B) Central extensor hood C) Palmar fascia D) Ulnar nerve Volar plate ultrasound image Diagnosis Diagnosis of a dorsal dislocation is typically made clinically based on the visible deformity seen. The patient will also have a decrease in their range of motion. Soft tissue structures should be assessed, as a dorsal dislocation of the PIP joint can injure the volar plate.
If the joint is already relocated prior to evaluation, then checking for joint stability is necessary. Radiographs are also taken to rule out concomitant fracture after reduction. Soft tissue support of the PIP joint https://youtu.be/Tp1x8g2Ng2k Video .
If you are experiencing symptoms that may be related to sideline management of pip dislocation, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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