Phalangeal Fractures: Anatomy, Injuries and Treatment-Fracture Dislocation of the Finger Joints

Fracture Dislocation of the Finger Joints

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Fracture dislocations of the finger joints are challenging injuries that require early recognition and treatment. The goal of treatment is to achieve stable concentric reduction of the joint and maintain joint stability while allowing for early active range of motion. Treatment options include splinting, pinning, external fixation, open reduction internal fixation, volar plate arthroplasty, and hemihamate arthroplasty, with the choice of treatment depending on the specific fracture pattern. The treatment algorithm varies for different joints—the proximal interphalangeal (PIP) joint, distal interphalangeal (DIP) joint, and metacarpophalangeal (MCP) joint. Several studies have reported on the outcomes of different treatment techniques, such as extension block splinting and pinning for PIP joint fractures, external fixation and dynamic traction for unstable or comminuted PIP joint fractures, open reduction internal fixation for stable fractures, and volar plate arthroplasty or hemihamate arthroplasty for complex PIP joint fractures. For DIP joint fracture dislocations, conservative management is often effective, but surgical treatment may be necessary in some cases. MCP joint dislocations can be treated with closed reduction or surgical reduction via a volar or dorsal approach. Overall, management of fracture dislocations requires careful assessment, appropriate treatment selection, and close follow-up to achieve optimal outcomes and minimize complications such as stiffness, pain, and swelling.

Keywords

fracture dislocations

finger joints

treatment

splinting

pinning

open reduction internal fixation

volar plate arthroplasty

hemihamate arthroplasty

conservative management

surgical treatment