Abstract
The proximal interphalangeal joint (PIPJ) is commonly injured. Many of these injuries are relatively minor, but the joint is unforgiving and frequently becomes stiff. Early appropriate treatment will minimalize long-term problems and facilitate earlier safe return to sport. This chapter covers the essential anatomy and behaviour of these joints, common injury patterns and treatment as well as the rationale and pitfalls in management.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Day CS, Stern PJ. Fractures of the metacarpals and phalanges. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, editors. Green’s operative hand surgery. 6th ed. Philadelphia: Elsevier Churchill Livingstone; 2011. p. 239–90.
Freiberg A, Pollard BA, MacDonald MR, Duncan MJ. Management of proximal interphalangeal joint injuries. Hand Clin. 2006;22:235–42.
Hamer DW, Quinton DN. Dorsal fracture subluxation of the proximal interphalangeal joint treated by extension block splintage. J Hand Surg. 1992;17B:586–90.
Liodaki E, Xing SG, Mailaender P, Stang F. Management of difficult intra-articular fractures or fracture dislocations of the proximal interphalangeal joint. J Hand Surg. 2015;40E(1):16–23.
Matev I. The boutonniere deformity. Hand. 1969;1:90–5.
Merrell G, Slade JF. Dislocations and ligament injuries in the digits. In: Wolfe SW, Hotchkiss RN, Pedersen WC, Kozin SH, editors. Green’s operative hand surgery. 6th ed. Philadelphia: Elsevier Churchill Livingston; 2011. p. 291–309.
Newington DP, Craigen MA, Bennet GC. Children’s proximal phalangeal neck fractures with 180 rotation deformity. J Hand Surg. 1995;20B:353–6.
Shewring DJ, Miller AC, Ghandour A. Condylar fractures of the proximal and middle phalanges. J Hand Surg. 2015;40E(1):51–8.
Teoh LC, Yong FC, Chong KC. Advancement osteotomy for correcting condylar malunion of the finger. J Hand Surg. 2002;26B:31–5.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Questions and Answers
Questions and Answers
-
1.
What radiographs should be requested following a dislocation of the PIP joint?
-
2.
After reduction of a dislocation, there remains slight incongruency of the joint. What does this herald?
-
3.
What deformity of the finger may develop after an untreated injury to the central slip of the extensor tendon?
-
4.
Which finger is most susceptible to avulsion flake fractures from the palmer lip of the middle phalanx? What is the treatment?
-
5.
Why do most condylar fractures require operative stabilization?
Answers
-
A 1. PA and true lateral views of the joint.
-
A 2. Soft tissue interposition of the joint. Often the collateral ligament will be ruptured and the condyle on that side will be protruding through a rent in the extensor mechanism mandating exploration.
-
A 3. “Boutonniere” deformity. These are significant injuries to the PIPJ. The results of treatment, even when timely and appropriate, are often disappointing.
-
A 4. The middle finger, particularly in netball and basketball players. Mobilization of the digit and return to sport with “buddy taping” after 1–2 weeks.
-
A 5. Condylar fractures have an unstable fracture pattern. If they heal in a displaced position, this results in joint incongruity and deformity of the finger. A single lag screw inserted through a lateral approach yields good results.
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Shewring, D.J. (2019). Fractures and Dislocations of the Proximal Interphalangeal Joint. In: Hayton, M., Ng, C., Funk, L., Watts, A., Walton, M. (eds) Sports Injuries of the Hand and Wrist. In Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-02134-4_3
Download citation
DOI: https://doi.org/10.1007/978-3-030-02134-4_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-02133-7
Online ISBN: 978-3-030-02134-4
eBook Packages: MedicineMedicine (R0)