Delayed Closed Reduction and Percutaneous Fixation of a Neglected Volar Proximal Interphalangeal (PIP)...

Volar proximal interphalangeal (PIP) joint fracture-dislocations presenting more than two weeks after injury pose significant management challenges, as progressive soft tissue fibrosis and capsular contracture frequently necessitate open reduction. Reports of successful delayed closed reduction with long-term follow-up in this setting remain limited in the literature. We report an 18-year-old man who presented 16 days after injury with a neglected volar PIP fracture-dislocation of the left ring finger, managed with delayed closed reduction under sedation and fluoroscopic guidance the following day (17 days post-injury), followed by percutaneous fixation. At two-year follow-up, the patient achieved full PIP extension (0°), a flexion arc of 80°, and a QuickDASH score of 0/100, with no radiographic evidence of post-traumatic osteoarthritis. This case suggests that delayed closed reduction may remain feasible beyond two weeks in carefully selected patients, potentially avoiding open surgery while achieving satisfactory long-term functional and radiographic outcomes.