What is the diagnosis?
Dorsolateral dislocation of the proximal interphalangeal joint with an associated avulsion fracture.
What other feature of this injury would be readily evident on clinical inspection?
This is an open injury with the head of the proximal phalanx projecting through the skin and gas seen in the joint.
The proximal interphalangeal joint of the middle finger is dislocated, with the middle phalanx lying dorsal and lateral to the proximal phalanx. A small sliver of bone is seen on the palmar aspect of the head of the proximal phalanx consistent with a small avulsion fracture. The head of the proximal phalanx appears to project through the skin, consistent with an open injury.