Simultaneous Volar Dislocation of Distal Interphalangeal Joint and Volar Fracture-Subluxation of Proximal Interphalangeal Joint of Little Finger: A New Mechanism of Injury

Abstract

Simultaneous volar dislocation of distal interphalangeal (DIP) joint and volar fracture-subluxation of proximal interphalangeal (PIP) joint of the same finger has not been reported yet. A 19-year-old man was referred due to pain on the deformed left little finger after a ball injury. Radiographs showed volar dislocation of the DIP joint and dorsal lip fracture of the middle phalanx with volar subluxation of PIP joint of the little finger. This case was unique in terms of the mechanism of injury which was hyperflexion type in two adjacent joints of the same finger. The patient was treated by closed reduction of DIP joint dislocation and open reduction and internal fixation of the PIP joint fracture-subluxation and application of dorsal external fixator due to instability. Finally, full flexion of the PIP joint and full extension of the DIP joint were obtained but with 10 degree extension lag at the PIP joint and DIP joint flexion ranging from 0 degree to 30 degrees. Some loss of motion in small joints of the fingers after hyperflexion injuries should be expected.