Review Question - QID 486

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Phalanx Dislocations QID: 486 (OBQ08.100)

QID 486 (Type "486" in App Search)

A 28-year-old professional baseball player injures his middle finger sliding into the catchers shin guard at home plate. He complains of pain and deformity of the middle finger. A radiograph is provided in figure A. All of the following are true EXCEPT:

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Anatomic reconstruction of the articular surface is prognostic of clinical function

52%

1667/3180

Proximal interphalangeal joint subluxation precludes a normal gliding flexion arc

16%

523/3180

Hinging at the fracture site must be avoided

252/3180

Early motion should be initiated in postoperative therapy

17%

546/3180

Early degenerative arthritis can be expected if the joint is not adequately reduced.

170/3180

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The radiograph demonstrates a dorsal fracture dislocation of the proximal interphalangeal joint of the middle finger. Kiefhaber and Stern review the presentation, evaluation, and treatment of PIP fractures. Congruent reduction of the joint to allow the middle phalanx to glide around the proximal phalangeal head is paramount to prevent joint subluxation and instability. Anatomic reconstruction of the articular surface is desirable but not necessary for successful clinical outcome.