Dislocations and Ligament Injuries of the Hand-Fracture Dislocation of the Finger Joints

Fracture Dislocation of the Finger Joints

Pdf Summary

Fracture dislocations of the finger joints are challenging injuries with a difficult balance between stability and mobility. Treatment requires early recognition, stable reduction, and protected early active range of motion to maintain joint stability. The specific treatment depends on the fracture pattern and stability of the joint. For proximal interphalangeal (PIP) joint dorsal fracture dislocations, stable fractures in slight flexion can be managed with extension block splinting or pinning. Unstable or comminuted fractures can be treated with external fixation or dynamic traction. Open reduction internal fixation (ORIF) or hemihamate arthroplasty may be necessary for more complex injuries. Distal interphalangeal (DIP) joint fracture dislocations, also known as mallet fractures, are typically managed conservatively unless the joint is volarly subluxed. Volar subluxations can be treated with modified cerclage wire technique. DIP joint dorsal fracture dislocations may require volar plate arthroplasty. MCP joint dorsal fracture dislocations are treated with volar or dorsal approach. Closed reduction is usually successful for MCP joint volar dislocations, but in rare cases, a dorsal approach may be required. The treatment algorithm for these injuries is based on the specific injury pattern and joint stability. The postoperative protocol generally involves immobilization followed by early active range of motion exercises.

Keywords

fracture dislocations

finger joints

stability

treatment

reduction

active range of motion

joint stability

dorsal fracture dislocations

MCP joint

postoperative protocol