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Am Fam Physician 2022 Jun;105(6):631-639

Fairfax Family Medicine Residency Program and University of Virginia, Fairfax, VA, USA.

Finger fractures and dislocations are commonly seen in the primary care setting. Patients typically present with a deformity, swelling, and bruising with loss of function. Anteroposterior, lateral, and oblique radiography should be performed to identify fractures and distinguish uncomplicated injuries from those requiring referral. Read More

Ulus Travma Acil Cerrahi Derg 2022 Jun;28(6):876-878

Department of Orthopedics and Traumatology, Marmara University Pendik Training and Research Hospital, İstanbul-Turkey.

Isolated proximal and distal interphalangeal joint (DIPJ) dislocations are widely seen as a result of sporting injuries and major trauma. The combination of dorsal dislocation of the DIPJ in the same finger concomitant to traumatic dorsal dislocation of the proximal interphalangeal joint (PIPJ) is a rarely seen injury. The case is, here, presented of a 65-year-old female patient with proximal and DIPJ dislocation of the right-hand ring finger accompanied by volar and dorsal plate injuries in the proximal and distal joints. Read More

J Orthop Case Rep 2022 Jan;12(1):84-88

Department of Hand and Microsurgery, Hospital Universitario Fundación Santa Fe de, Bogotá, Colombia.

Introduction: Isolated palmar carpometacarpal dislocation of the small finger is infrequent, this injury often goes unnoticed in the evaluation at the emergency room, for which physical evaluation and X-ray findings can avoid missing this diagnosis. We describe a case report and propose a treatment algorithm for isolated dislocations of the carpometacarpal joint of the fifth finger to the palmar that is not diagnosed and treated early, using this algorithm, the surgeon will have a vision of the probable best treatment option.

Case Presentation: A 50-year-old with late presentation of palmar dislocation of the fifth metacarpal bone, the diagnosis that went unnoticed in the initial emergency assessment. Read More

Hand Clin 2022 May;38(2):269-279

University of Texas Medical Branch, 301 University Boulevard, McCullough 6.124, Galveston, TX 77555, USA. Electronic address:

Isolated dislocations of thumb CMC joints are rare injuries with serious functional implications. Patients suffering these injuries will have decreased pinch and grip strength. A high-energy, axially directed force on a flexed thumb typically causes dislocation. Read More

JBJS Rev 2021 09 9;9(9). Epub 2021 Sep 9.

Department of Hand Surgery, Hospital for Special Surgery, New York, NY.

»: While the majority of patients with trigger finger obtain excellent outcomes from nonoperative treatment or release of the A1 pulley, a subset of patients with advanced trigger finger, defined as trigger finger with loss of active or passive range of motion, may have incomplete symptom relief and warrant specific attention.

»: Advanced trigger finger is more refractory to complete symptom resolution from corticosteroid injection, and particular attention should be paid to incomplete improvement of flexion contractures.

»: Unlike simple trigger finger, the pathology in advanced trigger finger involves not only the A1 pulley but also the flexor tendon, including thickening and degeneration. Read More

J Hand Surg Glob Online 2021 Jul 2;3(4):228-232. Epub 2021 May 2.

Department of Orthopaedics, University of Ioannina, Ioannina, Greece.

Isolated volar metacarpophalangeal dislocations of fingers are extremely rare. There are few cases published in English and French literature. In this article, we aim to review the literature and present a case of isolated open volar dislocation of a finger. Read More

J Orthop Case Rep 2021 Sep;11(9):24-28

Department of Trauma and Orthopaedics, Arrowe Park Hospital, Arrowe Park Road, Wirral - CH49 5PE, UK.

Introduction: Carpo-metacarpal joint fracture-dislocations are rare injuries. They constitute less than 1% of all hand injuries [1]. They often go unnoticed [2]. Read More

J Orthop Case Rep 2021 Nov;11(11):84-87

Department of Orthopaedics, Grant Government Medical College, Mumbai. Maharashtra. India.

Introduction: Finger dislocations account for 5% of upper extremity injuries. Metacarpophalangeal (MCP) joint/Kaplan dislocations post-trauma are of rare occurrence. An MCP joint dislocation is considered simple when it can be managed by closed reduction and considered complex when open reduction is necessary. Read More

J Wound Care 2022 Apr;31(4):340-347

Ninewells Hospital, Dundee, UK.

Objective: This study aimed to explore the efficacy of the IV3000 semi-occlusive, transparent adhesive film dressing in the non-surgical management of simple as well as more complex fingertip injuries.

Method: In this qualitative study, patients with fingertip injuries were prospectively recruited and treated conservatively with the dressing between 2015 and 2017. Inclusion criteria included any fingertip injury with tissue loss and patient consent for non-surgical treatment consistent with the study protocol. Read More

J Hand Surg Am 2022 Mar 4. Epub 2022 Mar 4.

Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD. Electronic address:

Purpose: Several improvised dynamic external fixation devices are used for treating unstable dorsal proximal interphalangeal (PIP) joint fracture-dislocations. We compared the effectiveness of 3 constructs for simulated dorsal PIP joint fracture-dislocations in a cadaver model.

Methods: We tested 30 digits from 10 fresh-frozen, thawed cadaver hands. Read More

Hand Surg Rehabil 2022 06 12;41(3):281-295. Epub 2022 Feb 12.

Service de chirurgie orthopédique et traumatologique, chirurgie plastique, Centre Hospitalier Régional Universitaire de Besançon, 3 Boulevard Fleming, 25000 Besançon, France.

Traumatic lesions around the base of the thumb have special features due to the location and structure of the joint and its inherent potential instability. This causes different fracture patterns, which are mostly isolated around the metacarpal base but can also involve just the trapezium or both. Exceptionally, there may be isolated dislocation. Read More

Hand (N Y) 2022 Jan 7:15589447211066352. Epub 2022 Jan 7.

Boston Medical Center, MA, USA.

Background: Proximal interphalangeal (PIP) joint fracture-dislocations can be technically challenging injuries to treat, and no technique has proven to be superior nor lead to predictably good outcomes. We describe our experience of treating unstable dorsal fracture-dislocations of the PIP joint with extension-block pinning (EBP) at our institution over a 22-year period.

Methods: In all, 23 patients with 24 unstable dorsal fracture-dislocations of the PIP joint treated with EBP between January 1998 and October 2020 were identified. Read More

J Hand Surg Eur Vol 2022 03 23;47(3):308-313. Epub 2021 Nov 23.

Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Read More

Prim Care 2021 Dec 8;48(4):707-728. Epub 2021 Oct 8.

Tidelands Health Family Medicine Residency Program, 4320 Holmestown Road, Myrtle Beach, SC 29588, USA.

Pediatric patients are frequently evaluated in primary care clinics. Thus, there exists a need to understand common pediatric problems and to acquire a degree of familiarity with pediatric procedures. This article will review techniques and the current evidence for frequently performed pediatric procedures, including umbilical granuloma chemocautery, frenotomy, suture ligation of type B postaxial polydactyly, reduction of nursemaid's elbow, hair tourniquet removal, and tympanometry. Read More

J Athl Train 2021 Sep;56(9):980-992

Department of Exercise Sciences, Brigham Young University, Provo, UT.

Context: As part of clinical practice, athletic trainers (ATs) provide immediate management of patients with acute joint dislocations. Management techniques may include on-site closed joint reduction of the dislocated joint. Although joint reduction is part of the 2020 educational standards, currently practicing ATs may have various levels of exposure, knowledge, and skills. Read More

JBJS Case Connect 2021 09 3;11(3). Epub 2021 Sep 3.

Kusum Superspeciality Orthopaedic Centre, Sakinaka, Andheri, Mumbai.

Case: Closed injury of the proximal interphalangeal joint (PIPJ), where the dorsally displaced epiphysis is lying on the dorsum of PIPJ, is sometimes called a jockeyed epiphyseal fracture (radiographs give an impression jockey sitting on a horse). We describe its variation in a 7-year-old boy who had a dorsally displaced epiphyseal fracture of the middle phalanx accompanied by fracture of the proximal phalanx. He was treated with open reduction and relocation of the epiphysis. Read More

J Am Acad Orthop Surg 2021 Nov;29(22):943-950

From the Attending Hand Surgeon, New York Hand & Wrist Center of Lenox Hill, New York, NY (Rabinovich, Beldner, and Polatsch), and the Attending Hand Surgeon, Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, CA (Shin).

The basal joint complex of the thumb provides the framework necessary for function of the human hand. Although its unique saddle articulation allows for a wide range of motion necessary for routine function of the hand, it is rendered inherently unstable because of poor bony congruency and reliance on its capsuloligamentous support. Painful instability of this joint can stem from several causes including traumatic dislocation, various hypermobility conditions, and chronic overuse and microtrauma. Read More

Hand Surg Rehabil 2021 Dec 9;40(6):765-770. Epub 2021 Jul 9.

SOS Main Grenoble, Unité de Chirurgie Réparatrice, de la Main et des Brûlés, Hôpital Albert Michallon, CHU de Grenoble, avenue du Marquis-de-Grésivaudan, BP 217, 38043 Grenoble cedex 09, France.

The goal of this study was to describe the long-term functional outcomes of the procedure described by Dubert (stabilized arthroplasty with intermetacarpal arthrodesis) for painful carpometacarpal impingement of the little finger. Between 2005 and 2017, 8 patients (1 woman and 7 men) were operated on who had a mean age of 38 years (24-53 years). Seven cases were post-traumatic (malunion) and one was due to septic arthritis. Read More

SAGE Open Med Case Rep 2021 3;9:2050313X211021180. Epub 2021 Jun 3.

Division of Plastic & Reconstructive Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.

Complex dislocation of the metacarpophalangeal joint of the index finger is rare and often requires surgical intervention. Here, we present a case of an index finger metacarpophalangeal joint dislocation requiring open reduction due to obstruction by a displaced volar plate and the intra-articular entrapment of a sesamoid bone. Surgical approach was performed dorsally, allowing easy visualization of the volar plate and sesamoid bone as well as minimizing risk to the radial digital nerve to the index finger. Read More

Acta Biomed 2021 04 30;92(S1):e2021034. Epub 2021 Apr 30.

Medicine Hospital, Istanbul, Turkey.

We present an 30 year-old female patient with a volar subluxation of the metacarpophalangeal joint of the thumb.Dislocation  of the metacarpophalangeal joint is rare ; volar subluxation is much more rare. Open reduction was performed through a dorsal incision because of the soft tissue interposition. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):158-165

Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé, Nancy University Hospital, Nancy, France.

The purpose of this retrospective study was to report and compare the outcomes of the MAIA prosthesis and trapeziectomy for trapeziometacarpal osteoarthritis. We included 92 consecutive patients (8 men, 84 women) with a mean age of 57 years (range 44-75 years) who underwent trapeziectomy (44 patients) or trapeziometacarpal joint replacement with a MAIA prosthesis (48 patients) for painful osteoarthritis. All patients were evaluated (pain, range of motion, strength, function, X-rays) by an independent examiner. Read More

J Pediatr 2021 Jul 2;234:276-277. Epub 2021 Apr 2.

Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy; Institute for Maternal and Child Health, Italian Research Hospital "Burlo Garofolo", Trieste, Italy.

J Wrist Surg 2021 Apr 27;10(2):164-168. Epub 2020 Aug 27.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

 Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable.  We report the case of a 17-year-old boy involved in a vehicular accident. Read More

Case Rep Orthop 2021 15;2021:6684553. Epub 2021 Mar 15.

2nd Orthopaedic Department, General Hospital of Thessaloniki "Papageorgiou", Ring Road-N. Eukarpia, 56403 Thessaloniki, Greece.

Double interphalangeal joint dislocation of the same finger is a rare condition. We report two cases of adolescent athletes with distal and proximal interphalangeal joint dislocation. The diagnosis was confirmed with plain radiograph, while anatomical reduction was easily obtained with gentle longitudinal traction. Read More

Tech Hand Up Extrem Surg 2021 Mar 24;26(1):2-6. Epub 2021 Mar 24.

Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Proximal interphalangeal joint injuries are common and are a major risk for functional deficits of the finger that affect range of motion and grip strength. Impacted intra-articular fractures and fracture dislocations of the middle phalanx base are challenging to treat because of troublesome joint reduction and difficulties in achieving articular congruity. Although treatment algorithms have been published, the anatomically delicate proximal interphalangeal joint often remains incomplete in function and may result in post-traumatic pain, stiffness, and osteoarthritis. Read More

Orthop Traumatol Surg Res 2021 09 9;107(5):102852. Epub 2021 Feb 9.

Olympia Hospital & Research Centre, Trichy, Tamilnadu, India. Electronic address:

Introduction: Several isolated closed dislocations of the dorsal interphalangeal joint are reported, and sometimes they may be associated with other fractures/dislocations. Less is known about the open dorsal dislocation of the distal interphalangeal joint.

Hypothesis: Open dorsal dislocations are stable after reduction and prone to develop dorsal interphalangeal joint stiffness. Read More

Hand (N Y) 2021 11 24;16(6):NP10-NP14. Epub 2021 Jan 24.

McMaster University, Hamilton, ON, Canada.

This article describes the first case of successful nerve grafting for posterior interosseous nerve (PIN) palsy secondary to radiocapitellar joint entrapment 2 years following closed reduction (CR) of a pediatric Monteggia fracture-dislocation (MFD). Patient notes were examined. The literature was reviewed to determine whether similar cases or techniques had been reported. Read More

BMC Musculoskelet Disord 2021 Jan 4;22(1). Epub 2021 Jan 4.

Department of Hand Surgery, Beijing Ji Shui Tan Hospital and the 4th Medical College of Peking University, Xin jie kou dong jie 31, Xi Cheng Qu, Beijing, 100035, China.

Background: Restoration of joint congruity is an important factor for the prevention of subsequent arthritis in patients with Bennett's fracture. Surgical treatment of Bennett's fracture is thus generally recommended for displaced intra-articular fractures to the proximal aspect of the thumb metacarpal. Fluoroscopic examination is used to evaluate the adequacy of closed reduction after pinning of Bennett's fracture. Read More

J Hand Microsurg 2020 Oct 10;12(Suppl 1):S9-S15. Epub 2020 Aug 10.

Department of Orthopaedic Surgery, Jersey City Medical Center-RWJBarnabas Health, Jersey City, New Jersey, United States.

Proximal interphalangeal joint (PIPJ) fractures and fracture-dislocations are common hand injuries and recognition of this injury pattern is essential in the management of these fractures. Although a variety of treatment options have been reported in the literature, the optimal treatment remains controversial. MEDLINE, EMBASE, and The Cochrane Library Database were screened for treatment strategies of PIPJ fracture and fracture-dislocation. Read More

Arch Bone Jt Surg 2020 Nov;8(6):739-743

Department of Orthopedics, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Proximal interphalangeal (PIP) fracture-dislocation is a relatively common injury that results from "jamming" a finger. Treatment hinges on the degree of articular surface involvement, which determines stability of the joint. For unstable injuries, a variety of surgical interventions have been described including extension block pinning, open reduction internal fixation, volar plate arthroplasty, static or dynamic external fixation, and hemi-hamate reconstruction. Read More