Hand Case 7 Background
Volar PIP dislocation with ring on finger (with fracture fragment)
Dislocations of the PIP joint are the most common ligament injuries in the hand. The mechanism of injury is an axial load and hyperextension, and is often sports-related. There are three types: dorsal, lateral (usually with ulnar deviation), and volar. Simple dorsal dislocations are most common. Volar dislocations are rare.
The DIP joint, because of additional stabilization, is rarely dislocated but often associated with an open wound when dislocated. The joint is likely contaminated, and treatment should include copious irrigation, suturing, and splinting with prophylactic antibiotics.
Rings are problematic in distal extremity injuries with swelling. They constrict and can act as tourniquets.