Abstract
In children, injuries about the distal interphalangeal (DIP) joint most commonly are Salter–Harris I epiphyseal fractures where the joint stays congruent and is not disrupted. Extrusion of the epiphyseal fragment (or epiphyseal dislocation) is a very rare injury, and few cases have been reported in the literature. We report a case of an irreducible dorsal fracture dislocation of the DIP joint, with the epiphysis being almost devoid of soft tissues and angulated 90°. The joint capsule, volar plate, collateral ligaments and extensor tendon all appear to be intact. The extensor tendon inserts slightly more distal on the distal phalanx than usual, allowing for the epiphysis to displace, with the extensor tendon still intact. Our case demonstrates that subtle variations in anatomy can cause alternative fracture patterns about the DIP joint.
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