OrthoNet

DISLOCATIONS-DIP Joint

Simple DIP Dislocations

Pure dislocations of the finger DIP or thumb IP joints are RARE - usually these are mallet fracture dislocations with volar subluxation of the distal phalanx (dorsal fracture dislocations are rare also).
When a pure dislocation occurs, it is usually dorsal, with an open wound.

Treatment
- closed reduction and splinting, 3 weeks
- if open, irrigation and debridement, reduction, splint

Irreducible DIP Dislocations

Five distinct mechanisms:
1. pure dorsal dislocation with entrapped volar plate - probably most common
2. entrapped FDP
3. entrapped osteochondral fracture
4. buttonholing of the distal condyles of the middle phalanx through the FDP
5. chronic dislocation

Treatment
- if truly irreducible, treat with open reduction, then a brief period of immobilization
- chronic dislocations (after 2-3 weeks) likely require open reduction, which can be done from the dorsal, volar, or midlateral sides.