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An irreducible phalangeal epiphyseal fracture-dislocation. A case report
Insights
A rare pediatric proximal interphalangeal joint injury involved irreducible dislocation and rotational displacement in a 20-month-old infant. Open reduction was necessary due to the unique fracture characteristics.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Pediatric Trauma
Background:
- Proximal interphalangeal (PIP) joint injuries are common in children.
- Epiphyseal fractures and dislocations can occur, but specific patterns may be rare.
Observation:
- A 20-month-old infant presented with an irreducible dorsal dislocation of a PIP joint.
- The injury involved a Salter-Harris Type I fracture with 90-degree rotational displacement of the middle phalanx epiphysis.
- This specific injury pattern appears to be previously undescribed in medical literature.
Findings:
- The irreducible nature of the dislocation and rotational displacement necessitated surgical intervention.
- Open reduction was performed using both volar and dorsal incisions.
- Intact collateral ligaments and extensor central slip prevented adequate joint distraction for closed reduction.
Implications:
- This case highlights a unique and previously unreported epiphyseal fracture-dislocation of the pediatric PIP joint.
- It underscores the importance of considering complex fracture patterns in pediatric hand injuries.
- Management requires tailored surgical approaches when closed reduction is not feasible.
Abstract:
A 20-month-old infant sustained an irreducible epiphyseal fracture-dislocation of a proximal interphalangeal joint. The dorsal dislocation of the joint was associated with a 90 degree rotational displacement (Salter-Harris Type I fracture) of the epiphysis of the middle phalanx. This injury, which seems not to have been described previously, required open reduction through both volar and dorsal incisions because the intact collateral ligaments and extensor central slip did not permit adequate distraction of the joint.