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J Orthop Case Rep 2018 May-Jun;8(3):68-70

Department of Orthopedics and Traumatology, Istanbul University, Turkey, Istanbul.

Introduction: Fracture-dislocations of the carpometacarpal (CMC) joints are pretty uncommon injuries with an incidence of 1%. A 17-year-old male was referred due to multiple traumas following a car accident with Glasgow Coma Score of 9.

Case Report: Simultaneous metacarpophalangeal dislocation and CMC fracture-dislocation of the ring finger were present in the 4th finger (ring finger) of the right hand. Read More

Ochsner J 2018 ;18(4):398-401

Department of Orthopedics, Ochsner Clinic Foundation, New Orleans, LA.

Background: Metacarpophalangeal (MCP) joint dislocations are the result of a hyperextension injury. Complex MCP joint dislocations-those that are irreducible to closed maneuvers and require surgical intervention-are considered uncommon, even in the pediatric population. Although several structures have been identified that contribute to irreducible dislocations, the volar plate is the most significant barrier to reduction through interposition into the MCP joint. Read More

Musculoskelet Surg 2018 Oct 22. Epub 2018 Oct 22.

Department of Hand Surgery, Singapore General Hospital, The Academia, 20 College Road, Singapore, 169856, Singapore.

Aim: This study reviews the surgical outcomes of using dorsal buttress plate for open reduction and internal fixation of ulnar (5th, or 4th and 5th) CMCJ fracture subluxation or dislocations.

Methods: A retrospective review of 11 patients at our center who underwent operative fixation with dorsal buttress plating technique was performed. The surgery was performed between February 2012 and March 2017. Read More

J Orthop Sci 2018 Nov 9;23(6):959-966. Epub 2018 Aug 9.

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Kasumi, 1-2-3, Minami-ku, Hiroshima, Hiroshima 734-8551, Japan.

Background: Dynamic external fixation is a useful treatment option for unstable fracture-dislocations of the proximal interphalangeal (PIP) joint, because it simultaneously reduces axial pressure load on the joint surface, maintains congruent joint reduction, and permits early joint motion. However, most current devices are large, hindering finger movement, and unstable. To address these problems, we developed a dynamic external finger fixator, named the Micro Ortho Fixator. Read More

Hand (N Y) 2018 Jul 1:1558944718787859. Epub 2018 Jul 1.

2 University Hospital of Pisa, Italy.

Background: Complex periarticular fractures of the metacarpophalangeal joint (MCPJ) are often challenging to treat. Conservative and operative treatments are often burdened with stiffness, loss of function, and poor clinical outcome. These phenomena could be a direct consequence of long period of immobilization. Read More

Plast Reconstr Surg Glob Open 2018 May 18;6(5):e1729. Epub 2018 May 18.

Hand Surgery, Kantonsspital Baselland, Liestal, Switzerland.

The "jammed finger" is among the most common hand injuries and may include simple sprains, dislocations, fractures, and fracture-dislocations. In contrast, irreducible dislocations of the proximal interphalangeal joint are rare injuries. However, they must not be overlooked in the primary assessment, because persistent subluxation may lead to joint contracture, severely compromising hand function. Read More

J Med Case Rep 2018 Jun 7;12(1):157. Epub 2018 Jun 7.

Orthopedic Surgery Department of Ibn Sina Hospital, University Mohamed V, Rabat, Morocco.

Background: Divergent carpometacarpal joint dislocations of the fingers are very rare. Due to severe swelling and overlapping of bones on a radiograph of the wrist and hand, dislocations are missed. The purpose of this clinical case report is to highlight this unusual injury to avoid missing diagnosis. Read More

BMJ Case Rep 2018 May 7;2018. Epub 2018 May 7.

Orthopaedic Surgery, HagaZiekenhuis, The Hague, The Netherlands.

Dislocations of the carpometacarpal (CMC) joints are uncommon and are frequently missed on standard radiographs of the hand. Dislocations could be dorsal or palmar; dorsal dislocations are seen more frequently. Palmar dislocations can be either ulnopalmar or radiopalmar. Read More

Hand Surg Rehabil 2018 Jun 21;37(3):191-194. Epub 2018 Mar 21.

SOS mains, hôpital Privé Dijon Bourgogne, 22, avenue François-Giroud, 21000 Fontaine-lDijon, FranceFontaine-l.

Dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint of the long fingers are in most cases unstable. They require surgery, whose primary aim is to restore and maintain articular congruency. While numerous techniques exist to treat these injuries, none have been shown to be superior to any of the others in terms of outcomes and complications. Read More

Pan Afr Med J 2017 18;28:155. Epub 2017 Oct 18.

Department of Orthopaedic Surgery, University Hospital Sahloul, Sousse, Tunisia.

The long fingers' paddlefish carpometacarpal (CMC) dislocation is exceptional. Most dislocations occur after high energy trauma. Untreated, these lesions can result in chronic instability of the CMC joints and early osteoarthritis. Read More

Zhongguo Gu Shang 2017 Jul;30(7):664-668

Luoyang Bone-setting Hospital, Luoyang 471002, Henan, China.

Objective: To observe the effect of different manipulative reduction for children's distal radioulnar fracture and dorsal dislocation.

Methods: From June 2013 to June 2014, 80 children with distal radioulnar fracture and dorsal dislocation were treated by bone setting manipulative reduction including 51 males and 29 females with an average age of 6.5 years old ranging from 3 to 14 years old. Read More

J Hand Surg Eur Vol 2018 Jun 7;43(5):530-538. Epub 2018 Feb 7.

4 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, (NDORMS), University of Oxford, Oxford, UK.

Fracture-dislocations of the carpometacarpal joint (CMCJ) of the little ray involve dorsal subluxation of the metacarpal base and they may be associated with injury of neighbouring CMCJs. Different treatment options are described, with no clear consensus on their management. This study presents a systematic review of comparative studies describing the management of these injuries. Read More

J Hand Surg Asian Pac Vol 2018 Mar;23(1):111-115

† Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan.

We describe 4 cases of irreducible volar rotatory subluxation of the proximal interphalangeal (PIP) joint of the finger that required open reduction. All of the patients had radiographically proven (in lateral-view radiographs) volar rotatory subluxation of the PIP joint, without fracture. The causes of irreducibility were interposition of the lateral band about the condyle of the middle phalanx in 2 cases, interposition of the collateral ligament in 1 case, and scarring of the injured central slip in 1 case. Read More

Eklem Hastalik Cerrahisi 2017 Dec;28(3):164-70

Department of Orthopedics and Traumatology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, 34890 Kartal, İstanbul, Turkey.

Objectives: This study aims to retrospectively evaluate and compare the mid-term clinical follow-up results of patients who were treated with open or closed reduction due to carpometacarpal (CMC) fracture dislocation.

Patients And Methods: Medical charts of 15 patients (1 male, 14 females; mean age 32.5±10. Read More

Oper Orthop Traumatol 2017 Dec 25;29(6):509-519. Epub 2017 Oct 25.

Chirurgisch-Traumatologisches Zentrum, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland.

Objective: Anatomic reconstruction of the retropatellar articular surface and repair of the extensor mechanism of the knee joint. The osteosynthesis should allow immediate mobilization as part of an early functional postoperative rehabilitation protocol.

Indications: Displaced fractures of the patella, especially multifragment and comminuted fractures with a retropatellar incongruity or dislocation of >2 mm. Read More

Chin J Traumatol 2017 Oct 22;20(5):303-304. Epub 2017 Sep 22.

Department of Orthopaedic Surgery, Suwa Central Hospital, 4300 Tamagawa, Chino, Nagano 391-8503, Japan. Electronic address:

Locking of the metacarpophalangeal (MCP) joint is commonly caused by hyperextension of the thumb or moderate flexion of the index or middle finger. We report a rare case of vertical locking of the MCP joint of the little finger in a 16-year old female after blunt trauma to the little finger. The MCP joint was locked when positioned at approximately 90-degree-flexion and could not extend actively or passively. Read More

Open Orthop J 2017 29;11:1035-1040. Epub 2017 Aug 29.

Department of Orthopaedic Surgery, Hospital Sant Joan de Deu de Manresa (Fundació Althaia Xarxa Assistencial Universitària de Manresa), C/ Dr.Joan Soler, 1-3, 08243 Manresa, Barcelona, Spain.

Injuries of the carpometacarpal joints of the long fingers are infrequent and go often unnoticed if a thorough clinical exploration and complete radiological assessment is not carried out. The overall frequency of carpometacarpal joints injuries is of 1-2% among trauma of the wrist and the carpus. These are normally secondary to high energy trauma (such as a car or a motorbike accidents). Read More

Hand (N Y) 2017 09 22;12(5):NP51-NP54. Epub 2016 Sep 22.

1 Brown University, Warren Alpert Medical School, Department of Orthopaedic Surgery, Providence, RI, USA.

Background: Dislocation of all 5 carpometacarpal (CMC) joints of a single hand is a rare injury.

Methods: The literature regarding CMC fracture-dislocations was reviewed and a case was presented.

Results: The relevant literature was consolidated to clinically relevant categories including 'Clinical Presentation and Diagnosis,' 'Management of CMC Fracture Dislocation and Hamate Fractures,' and 'Outcomes. Read More

J Orthop Case Rep 2017 Mar-Apr;7(2):14-16

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Introduction: Isolated pure dislocation of the fifth carpometacarpal (CMC) joint is a very rare injury and classified depending on displacement of the metacarpal base. This rare injury is often difficult to recognize and is liable to be overlooked. The purpose of this case report is to present a patient with an isolated dislocation of the fifth CMC joint that was satisfactorily treated with closed reduction and ulnar gutter pop slab. Read More

Hand (N Y) 2018 01 16;13(1):40-44. Epub 2017 Feb 16.

6 Stryker Spine, Allendale, NJ, USA.

Background: Therapy programs to treat thumb carpometacarpal (CMC) arthritis may engage selective activation and reeducation of thenar muscles, particularly the first dorsal interosseous (FDI) and opponens pollicis (OP) to reduce subluxation of the joint. We describe the effect of simulated selective activation of the FDI and OP muscles upon radiographic subluxation of the thumb CMC joint.

Methods: In a cadaver model of CMC subluxation, loads were applied to the FDI, the OP, and then concomitantly at 0%, 25%, 50%, 75%, and 100% maximal loads and radial subluxation of the joint and reduction in subluxation was measured. Read More

J Hand Surg Am 2017 Jul 3;42(7):572.e1-572.e6. Epub 2017 May 3.

Department of Orthopaedic Surgery, Washington University School of Medicine/Barnes-Jewish Hospital, St. Louis, MO.

Purpose: Fractures of the base of the middle phalanx are particularly challenging. Dorsal fracture-subluxations/dislocations of the proximal interphalangeal (PIP) joint are relatively common, but the volar fracture-subluxation/dislocation, the so-called "central slip fracture," is quite rare. The current study presents our experience with surgically treated patients with central slip fracture subluxation/dislocation with a minimum of 1 year follow-up. Read More

Medicine (Baltimore) 2017 Mar;96(11):e6377

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Rationale: Elbow injury in children by improper treatment or a delay of more than 3 weeks could lead to old unreduced Monteggia fracture, which are difficult to manage. Conservative or normal surgical methods usually fail.

Patient Concerns: Herein, we present a 6-year-old boy with sustaining injury approximately 1 month to his left elbow. Read More

Tech Hand Up Extrem Surg 2017 Mar;21(1):22-27

Hand and Wrist Center of Houston, Houston, TX.

The more common dorsal fracture subluxations at the base of the middle phalanx have an intact dorsal buttress of articular surface in continuity with the shaft. Capitalizing on this foundation, various fixation methods have met with relatively equivalent success including Kirschner wires, screws only, nonlocking plate and screws, and external fixation. Pilon fractures are complete articular fractures, where the comminuted articular fragments lack any structural connection to the more distal shaft of the middle phalanx, and have largely relied upon external fixation traction systems. Read More

Trauma Mon 2016 Jul 15;21(3):e20686. Epub 2016 May 15.

Orthopaedics and Trauma Department, Ozel Antalya Memorial Hospital, Antalya, Turkey.

Introduction: The debate regarding the description on classification and nomenclature of the injury which includes olecranon fracture associated with radial neck fractures in children is ongoing. We report two pediatric cases that could not be classified in a Monteggia-equivalents system and were treated with open reduction and k-wire fixation. The aim of this study was to perform a systematic review regarding pediatric radial neck fractures associated with olecranon fractures and presentation of two pediatric cases of olecranon fractures associated with radial neck fractures with radiocapitellar dislocation. Read More

Hand Surg Rehabil 2016 09 27;35(4):288-291. Epub 2016 Jul 27.

Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.

The authors report and discuss the management of a 25-year-old male patient with a trapeziometacarpal joint dislocation complicated by a trapezium fracture. This injury combination is rare with only reported 15 cases. After closed reduction resulted in dorsal instability, anatomical reduction of the trapezium fracture and internal screw fixation were performed using an open approach. Read More

Case Rep Emerg Med 2016 14;2016:4962021. Epub 2016 Sep 14.

Emergency Department, Jolimont Hospital, 159 Ferrer Road, 7100 Haine Saint Paul, Belgium.

Posterior carpometacarpal (CMC) dislocation is a rare condition. Treatment is usually surgical though no strict consensus can be found upon literature review. If diagnosed early and no associated fractures are found, CMC dislocation could benefit from conservative treatment comprising closed reduction and splint immobilisation. Read More

J Hand Surg Asian Pac Vol 2016 10;21(3):422-4

* Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Iran.

Simultaneous volar dislocation of distal interphalangeal (DIP) joint and volar fracture-subluxation of proximal interphalangeal (PIP) joint of the same finger has not been reported yet. A 19-year-old man was referred due to pain on the deformed left little finger after a ball injury. Radiographs showed volar dislocation of the DIP joint and dorsal lip fracture of the middle phalanx with volar subluxation of PIP joint of the little finger. Read More

J Hand Surg Asian Pac Vol 2016 10;21(3):382-7

* Department of Hand & Reconstructive Microsurgery, National University Hospital, Singapore.

Background: Proximal interphalangeal joint (PIPJ) dorsal fracture dislocations (DFD) are challenging injuries. Treatment aims to achieve stability of the PIPJ after reduction so that early motion can be initiated. We studied how increasing articular destruction would affect post reduction stability and investigate the amount of traction and PIPJ flexion needed to maintain the reduction. Read More

J Hand Surg Am 2016 Sep 9;41(9):e259-62. Epub 2016 Jul 9.

Department of Orthopaedic Surgery, Regions Hospital, University of Minnesota, Saint Paul, MN. Electronic address:

Purpose: Complex metacarpophalangeal (MCP) dislocations require open surgical reduction, but surgeons disagree about the best surgical approach. We hypothesized that a dorsal approach would require less operative time than would a volar approach and result in a decreased need for a secondary approach.

Methods: We performed a retrospective chart review of all isolated irreducible dorsal MCP dislocations treated at 2 level 1 trauma centers between 2005 and 2015. Read More

J Hand Surg Am 2016 Aug 14;41(8):e229-33. Epub 2016 Jun 14.

Orthopedic Department, Emek Medical Center, Afula, Israel; Faculty of Medicine, Technion, Haifa, Israel.

Purpose: To describe the long-term follow-up results of complex dorsal metacarpophalangeal joint dislocation (MPJD). We hypothesize that there would be no long-term functional deficit in most patients, even with the presence of one of the familiar complications.

Methods: We describe 5 patients with a median follow-up of 13 (range, 7-36) years and review the literature focusing on follow-up and complications. Read More

J Craniofac Surg 2016 Jun;27(4):919-22

*The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education †Department of Oral and Maxillofacial Trauma and Plastic Aesthetic Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.

Objective: To comparatively assess the effectiveness of the supine position technique versus the conventional method, for the manual reduction of acute nontraumatic temporomandibular joint (TMJ) dislocation.

Methods: This randomized single blind trial included a total of 40 patients, aged 18 to 80 years presenting with acute nontraumatic TMJ dislocation. Based on the randomization procedure, patients were treated with either conventional method or the supine position technique method. Read More

J Hand Surg Am 2016 Jun 22;41(6):712-22. Epub 2016 Apr 22.

Robert A. Chase Hand and Upper Limb Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA. Electronic address:

Hand fractures are the second most common fracture of the upper extremity, and management of patients with these injuries is common for most hand surgery practices. In this article, we outline the principles of management of these injuries with a special focus on those that are common or complex. We also highlight recent innovations in the context of these injuries. Read More

Orthop Surg 2016 Feb;8(1):85-8

Department of Orthopaedics, Ninewells Hospital and Medical School, Dundee, UK.

Dislocation of any joint is an orthopaedic emergency and needs immediate attention by the attending physician. A delay in reducing a dislocated joint can lead to disastrous complications both immediately as well as in the long run. Although anterior dislocation of a shoulder joint is by far the commonest dislocation encountered by any emergency care physician, other joints may also get dislocated. Read More

Zhongguo Gu Shang 2016 Jan;29(1):18-20

Objective: To investigate the effect of U-shaped gypsum functional fixation after closed manipulative reduction for treatment of Colles' fractures.

Methods: From January 2011 to April 2014,47 cases of Colles fracture were treated by closed reduction and U-shaped gypsum functional fixation including 12 males and 35 females with an average age of 54.8 years old ranging from 8 to 72 years old. Read More

BMJ Case Rep 2016 Feb 1;2016. Epub 2016 Feb 1.

Department of Orthopaedics, Oxford Radcliffe NHS Trust, Banbury, UK.

A 39-year-old man fell at work sustaining dislocation of both the proximal and distal interphalangeal joints of his left little finger. The injuries were assessed and treated with closed reduction and stabilised by buddy taping. Early active range of movement was encouraged and a referral to physiotherapy was made. Read More

Unfallchirurg 2016 Feb;119(2):133-43; quiz 144-5

Handchirurgie, Vulpiusklinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland.

Joint fractures of the fingers often entail operative interventions in contrast to extra-articular fractures. These types of fracture are inclined to dislocate in addition to the actual fracture. The proximal interphalangeal (PIP) joint in particular often shows comminuted fractures due to the long leverage of the finger and a relatively small diameter of the joint. Read More

J Hand Surg Am 2016 Feb 22;41(2):196-202. Epub 2015 Dec 22.

Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland.

Purpose: To evaluate the outcomes of extension block pinning used to treat unstable dorsal fracture dislocations of the proximal interphalangeal (PIP) joint. The factors affecting the functional outcome were analyzed.

Methods: A series of 53 patients with 55 dorsal fracture dislocations of the PIP joint treated with closed reduction and extension block pinning were retrospectively reviewed. Read More

J Hand Surg Am 2016 Feb 18;41(2):294-305. Epub 2015 Dec 18.

Robert A. Chase Hand and Upper Limb Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA. Electronic address:

The proximal interphalangeal (PIP) joint may be affected by many conditions such as arthropathy, fractures, dislocations, and malunions. Whereas some of these conditions may be treated nonsurgically, many require open surgical intervention. Open interventions include implant arthroplasty or arthrodesis for arthropathy, open reduction internal fixation, or hemi-hamate arthroplasty for dorsal fracture-dislocations. Read More

Eur J Trauma Emerg Surg 2016 Feb 11;42(1):37-42. Epub 2015 Dec 11.

Department of Trauma and Hand Surgery, University Hospital, Duesseldorf, Germany.

Purpose: Injuries to the carpometacarpal (CMC) joints are rare. The most common CMC fracture dislocations occur in the ring and small finger CMC joints. The aim of this study was to review the structured diagnostic procedure and different treatment options. Read More

Clin Orthop Surg 2015 Dec 13;7(4):430-5. Epub 2015 Nov 13.

Department of Orthopaedic, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India.

Background: Carpometacarpal joint fracture dislocation of the second to fifth finger is a rare hand injury associated with high energy trauma. Due to severe swelling and overlapping of bones on the radiograph of wrist-hand, dislocations are missed. We reported a series of six patients with rare carpometacarpal joint fracture dislocation treated with open reduction. Read More

Adv Emerg Nurs J 2015 Oct-Dec;37(4):252-7

School of Nursing & Health Sciences, Robert Morris University, Moon Township, Pittsburgh, Pennsylvania (Dr Ramponi); Heritage Valley Health System, Sewickley, Pennsylvania (Dr Ramponi); Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Cerepani).

Finger dislocations are common injuries that are often managed by emergency nurse practitioners. A systematic physical examination following these injuries is imperative to avoid complications. Radiographic views, including the anteroposterior, lateral, and oblique views, are imperative to evaluate these finger dislocations. Read More

Oper Orthop Traumatol 2015 Oct 16;27(5):414-26. Epub 2015 Sep 16.

Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Sektion Handchirurgie und Mikrochirurgie, Universitätsklinikum Münster, Münster, Deutschland.

Objective: Restoring stability and preventing subluxation/dislocation of the trapeziometacarpal (first carpometacarpal = CMC-I) joint while preserving mobility.

Indications: Posttraumatic, acquired or congenital instability of the CMC-I joint.

Contraindications: Existence of osteoarthritis of the CMC-I joint. Read More

Case Rep Orthop 2015 16;2015:698928. Epub 2015 Aug 16.

Department of Radiology, Evliya Çelebi Educational Research Hospital, 43050 Kutahya, Turkey.

Proximal interphalangeal joint dislocations are injuries observed frequently and caused by axial loading on the finger in the extension. In this paper we present a traumatic open finger dislocation due to a ball hitting a wrestler. It was successfully treated with reduction and the volar plate and collateral bond fixation were applied with absorbable sutures. Read More

J Hand Ther 2015 Oct-Dec;28(4):375-80; quiz 381. Epub 2015 Jun 27.

University of Minnesota, Department of Orthopaedic Surgery, 2450 Riverside Ave. South, Suite 200, Minneapolis, MN 55454, USA.

Introduction: Hand therapists selectively strengthen the first dorsal interosseus (FDI) to stabilize arthritic joints yet the role of the FDI has not yet been radiographically validated.

Purpose: To determine if FDI contraction reduces radial subluxation (RS) of the thumb metacarpal (MC).

Methods: Fluoroscopy was used to obtain true anterior-posterior radiographs of non-arthritic CMC joints: 1) at rest, 2) while stressed and 3) while stressed with maximal FDI contraction. Read More

Arch Pediatr 2015 Aug 2;22(8):830-9. Epub 2015 Jul 2.

Service de chirurgie orthopédique et traumatologique, CHU Habib-Bourguiba, 3029 Sfax, Tunisie; Faculté de médecine de Sfax, Sfax, Tunisie.

Introduction: Arthrogryposis is a condition existing at birth, seen in different diseases that have in common the existence of multiple joint stiffness. The clinical presentation is diversified and the functional prognosis depends on the etiology, which makes therapeutic options different from one case to another. The objective of this study was to describe clinical manifestations observed in arthrogrypotic patients and show the different therapeutic methods and functional results. Read More

Clin Orthop Relat Res 2015 Dec 18;473(12):3943-50. Epub 2015 Jun 18.

Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Yawkey Center, Massachusetts General Hospital, Suite 2100, 55 Fruit Street, Boston, 02114, MA, USA.

Background: Fracture-dislocations of the proximal interphalangeal joint are vexing because subluxation and articular damage can lead to arthrosis and the treatments are imperfect. Ideally, a surgeon could advise a patient, based on radiographs, when the risk of problems merits operative intervention, but it is unclear if middle phalanx base fracture characteristics are sufficiently reliable to be useful for surgical decision making.

Questions/purposes: We evaluated (1) the degree of interobserver agreement as a function of fracture characteristics, (2) the differences in interobserver agreement between experienced and less-experienced hand surgeons, and (3) what fracture characteristics and surgeon characteristics were associated with the decision for operative treatment. Read More

J Clin Orthop Trauma 2014 Jun 3;5(2):107-9. Epub 2014 Jun 3.

Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Department of Hand Clinic, Metin Sabancı Baltalimanı Kemik Hastalıları Hastanesi Rumelihisarı, Cad. No: 62, Baltalimani, Sarıyer, Istanbul 34470, Turkey ; Associate Professor, Metin Sabancı Baltalimanı Osteopathic Training and Research Hospital, Department of Hand Clinic, Metin Sabancı Baltalimanı Kemik Hastalıları Hastanesi Rumelihisarı, Cad. No: 62, Baltalimani, Sarıyer, Istanbul 34470, Turkey.

Background: Simultaneous dislocation of the proximal and distal interphalangeal joints of the same finger is a rare event. In literature simultaneous double interphalangeal dislocation in the same finger has been reported only one case in a skeletally immature patient which was a fourteen year old male. Our case was twelve years old which is the youngest case in the literature that has been reported. Read More

BMJ Case Rep 2015 May 15;2015. Epub 2015 May 15.

Department of Orthopaedics, Darent Valley Hospital, Dartford, UK.

Simultaneous dorsal dislocation of both interphalangeal joints (IPJs) in one finger is an uncommon injury. This injury usually occurs on the ulnar side of the hand involving ring and little fingers. We report a case of simultaneous dislocation of both IPJs in the middle finger. Read More

Ned Tijdschr Geneeskd 2015 ;159:A8577

MC Zuiderzee, Lelystad.

A 41-year-old woman presented to our emergency department after she tripped over a doorstep. Physical examination showed swelling and a stepladder deformity of the left little finger. Radiographs confirmed dorsal dislocation in both interphalangeal joints. Read More

Hand (N Y) 2015 Mar;10(1):88-93

Orthopaedic Hand Service, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.

Background: The purpose of this study is to evaluate the outcome of closed reduction and percutaneous Kirschner wire pinning in acute dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint.

Methods: Eight men and one woman were treated with closed reduction and percutaneous Kirschner wire pinning by one orthopaedic surgeon. The ring finger was injured in six patients, the small finger in two patients and the middle finger in one patient. Read More