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Dorsal PIP Dislocation

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1. Dorsal PIP Dislocation

Dorsal PIP Dislocation Dorsal PIP Dislocation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Dorsal PIP Dislocation Dorsal PIP (...) Dislocation Aka: Dorsal PIP Dislocation , Dorsal Proximal Interphalangeal Joint Dislocation , Finger Dislocation at Dorsal PIP Joint From Related Chapters II. Epidemiology Most common finger dislocation III. Mechanism Occurs due to blow to end of finger IV. Exam See Interphalangeal Joint Dislocation V. Signs Finger deformity at middle phalanx dorsum Volar plate tenderness to palpation VI. Complications Volar plate is commonly present Surgery may be needed if involves >30-40% of joint surface VII. Imaging

2018 FP Notebook

2. Volar PIP Dislocation

Dislocation Aka: Volar PIP Dislocation , Volar Proximal Interphalangeal Joint Dislocation , Finger Dislocation at Volar PIP Joint From Related Chapters II. Epidemiology Uncommon III. Signs: Central Slip Injury Inability to extend finger at PIP joint IV. Imaging Check Post-reduction films for V. Management Reduction Use similar method as for Dorsal Post-reduction (If reduction completed) Splint only the PIP in full extension for 6 weeks Referral Indications Early orthopedic in most cases involves more than (...) Volar PIP Dislocation Volar PIP Dislocation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Volar PIP Dislocation Volar PIP

2018 FP Notebook

3. Mid-Term Outcomes After Open Reduction Internal Fixation of Proximal Interphalangeal Joint Dorsal Fracture-Dislocations Through a Volar, Shotgun Approach and a Review of the Literature Full Text available with Trip Pro

Mid-Term Outcomes After Open Reduction Internal Fixation of Proximal Interphalangeal Joint Dorsal Fracture-Dislocations Through a Volar, Shotgun Approach and a Review of the Literature Proximal interphalangeal (PIP) fracture dislocations remain a complex injury pattern to treat. There are several treatment methods available aimed to restore stability, preserve range of motion, and reconstitute the articular surface. This study looked at the mid-term clinical and radiographic results of open (...) reduction internal fixation through a shotgun approach of comminuted PIP fracture dislocations.A retrospective review was conducted of all PIP fracture dislocations treated through a volar, shotgun approach at a single institution over a 15-year period. Patients identified were contacted and asked to return to the office for clinical and radiographic evaluation. Patient reported outcomes were assessed with the Michigan hand questionnaire (MHQ) and visual analog scale (VAS) for pain.5 patients returned

2017 The open orthopaedics journal

4. Dorsal PIP Dislocation

Dorsal PIP Dislocation Dorsal PIP Dislocation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Dorsal PIP Dislocation Dorsal PIP (...) Dislocation Aka: Dorsal PIP Dislocation , Dorsal Proximal Interphalangeal Joint Dislocation , Finger Dislocation at Dorsal PIP Joint From Related Chapters II. Epidemiology Most common finger dislocation III. Mechanism Occurs due to blow to end of finger IV. Exam See Interphalangeal Joint Dislocation V. Signs Finger deformity at middle phalanx dorsum Volar plate tenderness to palpation VI. Complications Volar plate is commonly present Surgery may be needed if involves >30-40% of joint surface VII. Imaging

2015 FP Notebook

5. Extension Block Pinning for Unstable Proximal Interphalangeal Joint Dorsal Fracture Dislocations. (Abstract)

Extension Block Pinning for Unstable Proximal Interphalangeal Joint Dorsal Fracture Dislocations. To evaluate the outcomes of extension block pinning used to treat unstable dorsal fracture dislocations of the proximal interphalangeal (PIP) joint. The factors affecting the functional outcome were analyzed.A series of 53 patients with 55 dorsal fracture dislocations of the PIP joint treated with closed reduction and extension block pinning were retrospectively reviewed. Additional percutaneous (...) a negative correlation with the range of motion of the injured PIP joint.The extension block pinning technique is a simple and valuable technique for treating unstable dorsal PIP fracture-dislocation injuries producing satisfactory long-term results.Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

2015 Journal of Hand Surgery - American

6. The Relationship Between Hemihamate Graft Size and Proximal Interphalangeal Joint Flexion for Reconstruction of Fracture-Dislocations: A Biomechanical Study. (Abstract)

The Relationship Between Hemihamate Graft Size and Proximal Interphalangeal Joint Flexion for Reconstruction of Fracture-Dislocations: A Biomechanical Study. The purpose of this study was to determine the relationship between hemihamate graft size and proximal interphalangeal (PIP) joint flexion in a biomechanical fracture-dislocation model.We simulated middle finger PIP fracture-dislocations in 5 cadaver hands by resecting 50% of the palmar articular surface of the middle phalanx (P2) base (...) . Fluoroscopy was used to confirm dorsal subluxation of the middle phalanx base after resection. A 10-mm osteochondral hamate graft was contoured to reconstruct the volar lip of the middle phalanx and was progressively downsized by 2-mm increments for each trial. A computer-controlled articulator and jig simulated active flexion and extension of the fingers. Maximum PIP flexion was measured at each graft size using fluoroscopy and digital imaging software. Clinically significant flexion block was defined

2018 Journal of Hand Surgery - American

7. Volar PIP Dislocation

Dislocation Aka: Volar PIP Dislocation , Volar Proximal Interphalangeal Joint Dislocation , Finger Dislocation at Volar PIP Joint From Related Chapters II. Epidemiology Uncommon III. Signs: Central Slip Injury Inability to extend finger at PIP joint IV. Imaging Check Post-reduction films for V. Management Reduction Use similar method as for Dorsal Post-reduction (If reduction completed) Splint only the PIP in full extension for 6 weeks Referral Indications Early orthopedic in most cases involves more than (...) Volar PIP Dislocation Volar PIP Dislocation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Volar PIP Dislocation Volar PIP

2015 FP Notebook

8. Biomechanical Characteristics of Hemi-Hamate Reconstruction Versus Volar Plate Arthroplasty in the Treatment of Dorsal Fracture Dislocations of the Proximal Interphalangeal Joint. (Abstract)

Biomechanical Characteristics of Hemi-Hamate Reconstruction Versus Volar Plate Arthroplasty in the Treatment of Dorsal Fracture Dislocations of the Proximal Interphalangeal Joint. To compare stability and range of motion after hemi-hamate reconstruction versus volar plate arthroplasty in a biomechanical proximal interphalangeal (PIP) joint fracture-dislocation model.Eighteen digits from 6 cadaver hands were tested. We created defects of 40%, 60%, and 80% in the palmar base of each digit's (...) middle phalanx, simulating an acute PIP joint fracture-dislocation. Each defect scenario was reconstructed with a hemi-hamate arthroplasty followed by a volar plate arthroplasty. A computer-controlled mechanism was used to bring each digit's PIP joint from full extension to full flexion via the digital tendons in each testing state, and in the intact state. During each testing scenario we collected PIP joint cinedata in a true lateral projection using mini-fluoroscopy. A digital radiography program

2014 Journal of Hand Surgery - American

9. The Central Slip Fracture: Results of Operative Treatment of Volar Fracture Subluxations/Dislocations of the Proximal Interphalangeal Joint. Full Text available with Trip Pro

The Central Slip Fracture: Results of Operative Treatment of Volar Fracture Subluxations/Dislocations of the Proximal Interphalangeal Joint. Fractures of the base of the middle phalanx are particularly challenging. Dorsal fracture-subluxations/dislocations of the proximal interphalangeal (PIP) joint are relatively common, but the volar fracture-subluxation/dislocation, the so-called "central slip fracture," is quite rare. The current study presents our experience with surgically treated (...) patients with central slip fracture subluxation/dislocation with a minimum of 1 year follow-up. We hypothesized that the majority of patients with a central slip fracture-subluxation/dislocation have poor outcomes.Thirteen patients with central slip fracture-subluxations/dislocation were identified from departmental billing records between 2003 and 2013. Nine patients completed the study follow-up examination and 8 were included in the final analysis. Clinical data assessed included age at injury, sex

2017 Journal of Hand Surgery - American

10. Flexor Surface Injury at the PIP Joint

Surface Injury at the PIP Joint Flexor Surface Injury at the PIP Joint Aka: Flexor Surface Injury at the PIP Joint , PIP Joint Volar Plate Injury , Volar Plate Injury From Related Chapters II. Mechanism Volar plate injured in hyperextension of affected joint Usually affects PIP joint Partial or complete tear or avulsion Often occurs when the finger is dislocated dorsally Associated with III. Signs Tenderness at affected joint at volar aspect Evaluate collateral ligaments for stability Range of motion (...) Flexor Surface Injury at the PIP Joint Flexor Surface Injury at the PIP Joint Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Flexor

2018 FP Notebook

11. Extensor Tendon Injury at the PIP Joint

Extensor Tendon Injury at the PIP Joint Extensor Tendon Injury at the PIP Joint Aka: Extensor Tendon Injury at the PIP Joint , PIP Central Slip Dislocation , Central Slip Extensor Tendon Injury , Boutonniere Deformity From Related Chapters II. Mechanism Central slip tears over PIP dorsum See Commonly occurs with ball striking dorsal finger Actively extended PIP joint forced into flexion Common basketball dislocation May also occur with volar dislocation of pip joint III. Signs See See See PIP joint (...) diffusely tender and swollen Maximal pain at midline dorsal proximal middle phalanx Pain on resisted finger extension Hold the PIP joint at 15-30 degrees flexion Patient unable to actively extend finger Passive extension still possible Assess for associated collateral ligament injury IV. Radiology: XRay finger Normal in most cases Small proximal middle phalanx avulsion V. Management Orthopedic referral indications Avulsion involving >1/3 of joint Passive extension of PIP not possible First 6 weeks

2018 FP Notebook

12. Dorsal Extension-Block Splint

Splint Dorsal Extension-Block Splint Aka: Dorsal Extension-Block Splint II. Indications Middle phalanx volar avulsion (larger avulsions with risk of dorsal subluxation) PIP joint dorsal dislocations (reduced and stable) III. Images IV. Technique Application Splint applied to dorsal surface of affected finger from distal finger nail to proximal s Tape the splint to finger over the MCP joint and the proximal phalanx PIP should be able to freely flex, but limited in extension by the splint position (...) Position Start with the splint angled over the PIP to 45 degrees (maximal PIP extension is 45 degrees) Decrease the angle by 15 degrees per week (45,30,15, and finally 0) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Dorsal Extension-Block Splint." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Procedure About FPnotebook.com is a rapid

2018 FP Notebook

13. Simultaneous double interphalangeal joints dislocation in a finger in a teenager Full Text available with Trip Pro

his right ring finger while playing football. Examination revealed a stepladder deformity. There was no sign of neurovascular damage. Radiographs showed dorsal dislocation of both the proximal and distal interphalangeal joints. Reduction of the double dislocation was easily achieved by simple longitudinal traction. The finger was splinted in the intrinsic plus position for 3 weeks and active range of motion was then allowed.The most prevalent cause of injury was a sport accident. The left hand (...) was less often involved than the right hand. The finger most often injured was the little finger followed by the ring finger, middle finger and the index finger. Closed reduction is the treatment of choice if there is no soft tissue interposition that prohibits the procedure. In most cases, longitudinal traction was sufficient for closed reduction.We report the second case of simultaneous proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints dislocations in one finger in a 12-year-old

2014 Journal of clinical orthopaedics and trauma

14. Simultaneous double dislocation of the interphalangeal joint of the same finger: a report of two cases Full Text available with Trip Pro

Simultaneous double dislocation of the interphalangeal joint of the same finger: a report of two cases Simultaneous dislocation of both the proximal and distal interphalangeal (PIP and DIP) joints in a finger is uncommon. Two patients were treated conservatively. Both two patients fell from a step-ladder and X-rays revealed dorsal dislocations of both PIP and DIP joints of their right little fingers. Manual reduction was easily achieved with gentle longitudinal traction. The mechanism (...) of the injury is believed to be hyperextension of both the DIP and PIP joints. Closed reduction is the treatment of choice and early active range of motion to prevent joint contracture should be recommended.

2014 The Pan African medical journal

15. Hand Dislocation (Treatment)

successful for dorsal proximal interphalangeal (PIP) joint dislocations. Volar dislocations are more problematic, especially if the deformity has a rotational component. For all closed reduction maneuvers, be gentle and limit the number of attempts to 2-3. Irreducible dislocations are usually caused by soft-tissue structures (eg, volar plate, collateral ligament, tendons) trapped in the joint, in which case the patient may need to be referred to a hand surgeon for open reduction (see below). Most dorsal (...) by injecting solution into a potentially confined space, volumes of 2-4 mL should not be exceeded. Digital block. Volar PIP dislocations without a rotational component are usually reducible with gentle traction. Place the wrist in the neutral position, and press dorsally on the base of the middle phalanx and volarly on the proximal phalanx. Although these injuries are usually treatable with closed reduction, they commonly involve an avulsion of the central slip of the extensor tendon. Volar PIP

2014 eMedicine.com

16. Hand Dislocation (Overview)

for normal hand function. The PIP and DIP joints are both supported on all 4 sides by similar soft-tissue structures, which include the volar plate on the palmar side (the integrity of which is essential for a stable reduction), collateral ligaments on the radial and ulnar sides, and the extensor complex (central slip, lateral bands, and hood) dorsally (see the image below). These structures attach to and reinforce the joint capsule. For a dislocation to occur, at least 1, often 2, and sometimes 3 (...) dislocations at the PIP joint, with the middle phalanx either tearing the central slip from its insertion or buttonholing through the transverse retinacular ligament between the central slip and a lateral band. Metacarpophalangeal joint The metacarpophalangeal (MCP) joint is thought to be an ellipsoid joint. The head of the metacarpal consists of medial and lateral condyles and is narrower on its dorsal surface than on its palmar surface; it fits into the concavity of the base of the proximal phalanx

2014 eMedicine.com

17. Hand Dislocation (Follow-up)

successful for dorsal proximal interphalangeal (PIP) joint dislocations. Volar dislocations are more problematic, especially if the deformity has a rotational component. For all closed reduction maneuvers, be gentle and limit the number of attempts to 2-3. Irreducible dislocations are usually caused by soft-tissue structures (eg, volar plate, collateral ligament, tendons) trapped in the joint, in which case the patient may need to be referred to a hand surgeon for open reduction (see below). Most dorsal (...) by injecting solution into a potentially confined space, volumes of 2-4 mL should not be exceeded. Digital block. Volar PIP dislocations without a rotational component are usually reducible with gentle traction. Place the wrist in the neutral position, and press dorsally on the base of the middle phalanx and volarly on the proximal phalanx. Although these injuries are usually treatable with closed reduction, they commonly involve an avulsion of the central slip of the extensor tendon. Volar PIP

2014 eMedicine.com

18. Hand, Fracture and Dislocations: Phalangeal

include the use of internal fixation in a reduced and stable fracture or plating a fracture that can be managed with a less invasive fixation technique. Previous References Hamilton SC, Stern PJ, Fassler PR, Kiefhaber TR. Mini-screw fixation for the treatment of proximal interphalangeal joint dorsal fracture-dislocations. J Hand Surg [Am] . 2006 Oct. 31(8):1349-54. . Haase SC, Chung KC. Current concepts in treatment of fracture-dislocations of the proximal interphalangeal joint. Plast Reconstr Surg (...) Hand Surg [Br] . Apr 2004. 29(2):130-134. Roth JJ, Auerbach DM. Fixation of hand fractures with bicortical screws. J Hand Surg [Am] . Jan 2005. 30(1):151-3. van Oosterom FJ, Ettema AM, Mulder PG, Hovius SE. Impairment and disability after severe hand injuries with multiple phalangeal fractures. J Hand Surg [Am] . Jan 2007. 32(1):91-5. Williams RM, Kiefhaber TR, Sommerkamp TG, Stern PJ. Treatment of unstable dorsal proximal interphalangeal fracture/dislocations using a hemi-hamate autograft. J Hand

2014 eMedicine Surgery

19. Joint Reduction, Finger Dislocation

(typically, lateral dislocations) Axial load Injury caused by direct pressure or crushing Types of dislocations Dislocations of the distal IP (DIP) joint of the second through fifth digits are relatively uncommon because of the stability afforded by the DIP joint’s flexor and extensor tendinous attachments. [ , ] Of the DIP joint dislocations that do occur, most are dorsal and are in combination with an open fracture. Dislocations of the proximal IP (PIP) joint of the second through fifth digits (...) are the most common dislocations within the hand; dorsal dislocations occur most frequently. [ , , ] If the PIP joint was reduced prior to medical evaluation, the dislocation must be identified as volar, dorsal, or lateral because if the resultant splinting is incorrect, it can result in the development of a . Dorsal PIP joint dislocations are typically due to a sports-related high-speed force to the distal finger, which, in turn, causes axial stress and hyperextension. [ ] They commonly are treated

2014 eMedicine.com

20. Hand Dislocation (Diagnosis)

for normal hand function. The PIP and DIP joints are both supported on all 4 sides by similar soft-tissue structures, which include the volar plate on the palmar side (the integrity of which is essential for a stable reduction), collateral ligaments on the radial and ulnar sides, and the extensor complex (central slip, lateral bands, and hood) dorsally (see the image below). These structures attach to and reinforce the joint capsule. For a dislocation to occur, at least 1, often 2, and sometimes 3 (...) dislocations at the PIP joint, with the middle phalanx either tearing the central slip from its insertion or buttonholing through the transverse retinacular ligament between the central slip and a lateral band. Metacarpophalangeal joint The metacarpophalangeal (MCP) joint is thought to be an ellipsoid joint. The head of the metacarpal consists of medial and lateral condyles and is narrower on its dorsal surface than on its palmar surface; it fits into the concavity of the base of the proximal phalanx

2014 eMedicine.com

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