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Distal Interphalangeal Joint Dislocation
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Contents
Other Names
- DIPJ Dislocation
- DIP Joint Dislocation
Background
- Traumatic injury to the distal interphalangeal joint
- Can be volar, dorsal, lateral with dorsal being far more common
Pathophysiology
- Dorsal fracture-dislocations occur as a result of hyperextension
- Volar fracture-dislocations occur as a result of failure of the central slip
- Impaction shear results from axial loading which can result in volar or dorsal dislocations
Risk Factors
- Unknown
Differential Diagnosis
- Fractures
- Dislocations
- Tendinopathies
- Ligament Injuries
- Neuropathies
- Arthropathies
- Nail Bed Injuries
- Pediatric Considerations
- Other
Clinical Features
- General: Physical Examination Hand
- Dislocation typically obvious on exam with deformity
- Important to assess integrity and stability of joint after reduction
Evaluation
Classification
- Dislocations: dorsal, volar, lateral
- Fracture-Dislocations: dorsal, volar
Management
Acute Management
- Consider digital block for pain control
- Dorsal reduction
- Flex wrist, hyperextend joint, apply traction and dorsal pressure to phalanx base
- If irreducible, likely soft tissue or bone interposed in joint (avulsion fracture, profundus tendor or volar plate)
- Volar reduction
- Flex wrist, hyperflex joint, apply traction and bring joint into extension
- If irriducible, consider volar plate interposition
Nonoperative
- First line therapy
- Dorsal: extension block splinting in slight flexion (prevent extension)
- Volar: extension splinting (prevent flexion)
Operative
- Failure of closed reduction
- Interposition of FDP tendon
Return to Play
- Needs to be updated
Complications
- DIPJ stiffness
- Mallet Finger
- Boutonniere Deformity
See Also
External
- Sports Med Review Hand Pain: https://www.sportsmedreview.com/by-joint/hand/
References
Created by:
John Kiel on 18 June 2019 23:09:30
Authors:
Last edited:
16 October 2022 00:17:09
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