Presentation
Trauma to the hand. Deformity of the 3rd and 4th fingers upon physical examination.
Patient Data
Dorsal dislocation of the proximal interphalangeal joint (PIPJ) of the 3rd and 4th fingers. The dislocation can be classified as a type I dorsal dislocation (hyperextension).
No fractures are seen.
Non-acute deformity of the 5th metacarpal.
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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