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Interphalangeal Dislocation Workup

  • Author: Grace M Young, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
 
Updated: Nov 12, 2015
 

Imaging Studies

Radiographs

Take anteroposterior, true lateral, and oblique radiographs of the affected digit. Obtain 3 views prior to and after reduction (see the images below).[12]

Anteroposterior view of distal interphalangeal (DIAnteroposterior view of distal interphalangeal (DIP) joint dislocation
Lateral view of distal interphalangeal (DIP) jointLateral view of distal interphalangeal (DIP) joint dislocation
Oblique view of distal interphalangeal (DIP) jointOblique view of distal interphalangeal (DIP) joint dislocation
Oblique view of proximal interphalangeal (PIP) joiOblique view of proximal interphalangeal (PIP) joint dislocation

Physeal, avulsion, or distal tuft fractures as well as osteochondral fragments are often subtle and seen only on 1 or 2 views.

Obtain stress views to assess joint stability.

Next

Procedures

See the list below:

  • Administer digital block anesthesia 10-15 minutes before any reduction maneuver.
  • Be sure to remove all rings.
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Contributor Information and Disclosures
Author

Grace M Young, MD Associate Professor, Department of Pediatrics, University of Maryland Medical Center

Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

James E Keany, MD, FACEP Associate Medical Director, Emergency Services, Mission Hospital Regional Medical Center, Children's Hospital of Orange County at Mission

James E Keany, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, California Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Tom Scaletta, MD President, Smart-ER (http://smart-er.net); Chair, Department of Emergency Medicine, Edward Hospital; Past-President, American Academy of Emergency Medicine

Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

References
  1. Van Ransbeeck H, De Smet L. Double dislocation of both interphalangeal joints in the finger. Case report and literature review. Acta Orthop Belg. 2004 Feb. 70(1):72-5. [Medline].

  2. Córdoba-Fernández A. Management of nonreducible lesser toe interphalangeal dislocation: an unusual injury. J Am Podiatr Med Assoc. 2012 May-Jun. 102 (3):252-5. [Medline].

  3. Chung S, Sood A, Lee E. Principles of management in isolated dorsal distal interphalangeal joint dislocations. Eplasty. 2014. 14:ic33. [Medline].

  4. Banerji S, Bullocks J, Cole P, Hollier L. Irreducible distal interphalangeal joint dislocation: a case report and literature review. Ann Plast Surg. 2007 Jun. 58(6):683-5. [Medline].

  5. Morisawa Y, Ikegami H, Izumida R. Irreducible palmar dislocation of the distal interphalangeal joint. J Hand Surg [Br]. 2006 Jun. 31(3):296-7. [Medline].

  6. Deshmukh NV, Sonanis SV, Stothard J. Irreducible volar dislocations of the proximal interphalangeal joint. Emerg Med J. 2005 Mar. 22(3):221-3. [Medline].

  7. Chinchalkar SJ, Gan BS. Management of proximal interphalangeal joint fractures and dislocations. J Hand Ther. 2003 Apr-Jun. 16(2):117-28. [Medline].

  8. Freiberg A, Pollard BA, Macdonald MR, Duncan MJ. Management of proximal interphalangeal joint injuries. Hand Clin. 2006 Aug. 22(3):235-42. [Medline].

  9. Cornwall R. Finger metacarpal fractures and dislocations in children. Hand Clin. 2006 Feb. 22(1):1-10. [Medline].

  10. Papadonikolakis A, Li Z, Smith BP, Koman LA. Fractures of the phalanges and interphalangeal joints in children. Hand Clin. 2006 Feb. 22(1):11-8. [Medline].

  11. Otani K, Fukuda K, Hamanishi C. An unusual dorsal fracture-dislocation of the proximal interphalangeal joint. J Hand Surg Eur Vol. 2007 Apr. 32(2):193-4. [Medline].

  12. Gilbert TJ, Cohen M. Imaging of acute injuries to the wrist and hand. Radiol Clin North Am. 1997 May. 35(3):701-25. [Medline].

  13. Joyce KM, Joyce CW, Conroy F, Chan J, Buckley E, Carroll SM. Proximal interphalangeal joint dislocations and treatment: an evolutionary process. Arch Plast Surg. 2014 Jul. 41 (4):394-7. [Medline].

  14. Kozin SH. Fractures and dislocations along the pediatric thumb ray. Hand Clin. 2006 Feb. 22(1):19-29. [Medline].

  15. Kannan RY, Wilmshurst AD. Unstable proximal interphalangeal joint dislocations: another cause. Emerg Med J. 2006 Oct. 23(10):819. [Medline].

  16. Bindra RR, Foster BJ. Management of proximal interphalangeal joint dislocations in athletes. Hand Clin. 2009 Aug. 25(3):423-35. [Medline].

  17. Nanno M, Sawaizumi T, Ito H. Irreducible palmar dislocation of the proximal interphalangeal joint of a finger evaluated by magnetic resonance imaging: a case report. Hand Surg. 2004 Dec. 9(2):253-6. [Medline].

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Anteroposterior view of distal interphalangeal (DIP) joint dislocation
Lateral view of distal interphalangeal (DIP) joint dislocation
Oblique view of distal interphalangeal (DIP) joint dislocation
Oblique view of proximal interphalangeal (PIP) joint dislocation
 
 
 
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