Challenge of the Week / Hand & Wrist / 01.10.20

A 27-year-old female patient suffered a fall earlier in the day and presents with right index finger deformity and pain. Radiographs show a simple volar proximal interphalangeal (PIP) dislocation. Closed reduction is performed under digital block anaesthesia, and post-reduction imaging shows concentric reduction. Treatment involving PIP extension splinting for 6 weeks is ordered to facilitate healing of which of the following structures?
    • Central slip
    • Simple volar dislocations of the PIP joint are concerning for a central slip rupture. PIP immobilization in extension for 6 weeks is appropriate to allow the central slip to heal without a gap.

 

  • Lateral bands

Simple volar dislocations of the PIP joint are concerning for injury to the central slip, not the lateral bands.

 

 

  • Collateral ligaments

Simple volar dislocations of the PIP joint are concerning for a central slip, not collateral ligament injury. Extension of the PIP joint tensions the accessory collateral ligaments.

 

 

  • Volar plate

Simple volar dislocations of the PIP joint are concerning for central slip, not volar plate injury. Extension of the PIP joint tensions the volar plate.

 

 

 

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