Simultaneous double interphalangeal joints dislocation in a finger in a teenager.

Abstract

Simultaneous dislocation of the proximal and distal interphalangeal joints of the same finger is a rare event. In literature simultaneous double interphalangeal dislocation in the same finger has been reported only one case in a skeletally immature patient which was a fourteen year old male. Our case was twelve years old which is the youngest case in the literature that has been reported. A 12-year-old male injured his right ring finger while playing football. Examination revealed a stepladder deformity. There was no sign of neurovascular damage. Radiographs showed dorsal dislocation of both the proximal and distal interphalangeal joints. Reduction of the double dislocation was easily achieved by simple longitudinal traction. The finger was splinted in the intrinsic plus position for 3 weeks and active range of motion was then allowed. The most prevalent cause of injury was a sport accident. The left hand was less often involved than the right hand. The finger most often injured was the little finger followed by the ring finger, middle finger and the index finger. Closed reduction is the treatment of choice if there is no soft tissue interposition that prohibits the procedure. In most cases, longitudinal traction was sufficient for closed reduction. We report the second case of simultaneous proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints dislocations in one finger in a 12-year-old non-athletic boy; which is the youngest case in the literature, managed by closed reduction and early mobilization, with excellent outcome.