- Discussion:
- usually presents as irreducible dislocation of PIP joint (as opposed to
dorsal dislocations which are usually reducible);
- rotatory dislocation involves buttonholing of one condyle of head of proximal phalanx
thru longitudinal rent in extensor hood between central slip and lateral band;
- see:
extensor mechanism of the digits
- Radiographs:
- on lateral view, look for true lateral profile of proximal phalanx & oblique profile of middle phalanx;
- Non Operative Treatment:
- with successful closed reduction, try buddy taping w/ full active ROM;
-
reduction:
- traction is applied to finger while MP & PIP joints are flexed to 90 deg;
- flexion relaxes volarly displaced lateral band, allowing it to slip back dorsally;
- reduction is confirmed w/ post reduction true lateral;
- Open Reduction:
- indicated with failure of closed reduction;
- proximal phalanx condyle may be button holed between central slip & lateral band;
