Post-traumatic trapped dislocations of the proximal interphalangeal joint

Area of Science:

• Orthopedic surgery
• Hand surgery
• Traumatology

Background:

• Proximal interphalangeal (PIP) joint dislocations are common hand injuries.
• Trapped dislocations of the PIP joint are an uncommon but significant subset.
• These injuries are frequently unrecognized, leading to delayed diagnosis and treatment.

Observation:

• Soft tissue structures, such as the extensor mechanism, collateral ligaments, volar plate, or flexor tendon sheath, can become entrapped within the joint.
• Entrapment can form a noose-like structure or directly interpose within the joint.
• Compound dislocations involving skin injury are also noted.

Findings:

• Diagnosis requires careful clinical examination and often imaging.
• Open reduction is mandatory for trapped dislocations.
• Simultaneous repair of injured soft tissues (extensor mechanism, ligaments, volar plate, tendon sheath, skin) is crucial.

Implications:

• Prompt and accurate diagnosis is key to successful management.
• Surgical intervention ensures joint stability and function restoration.
• Understanding the mechanism of soft tissue entrapment improves surgical planning and outcomes for these challenging injuries.