- Most common – dorsal dislocation of the PIP joint, associated fracture of the volar articular surface of the middle phalanx.
- Most stable when reduced in a flexed position.
- Dislocations with fractures of <30% of the joint surface that prove stable after closed reduction are buddy-taped to an adjacent finger
- Extension block pinning is indicated for treating unstable dorsal PIP fracture-dislocation and fractures that require excessive flexion to maintain the joint reduction.
- Dynamic external fixation is unique in its ability to treat complete articular fractures where the dorsal and volar articular surfaces are fractured off the middle phalanx
- Other treatment methods include hook plate, mini plate fixation, and arthroplasty
- Volar PIP fracture dislocations occur when the central slip of the extensor mechanism is fractured off of the middle phalanx. They require suture fixation with a bone anchor and suture into the central slip
