An isolated rotatory volar dislocation of the proximal interphalangeal joint of the little finger: what management? About a rare case

An isolated rotatory volar dislocation of the proximal interphalangeal joint of the little finger: what management? About a rare case

Naoufal Elghoul^1,&, Ali Zine¹

¹Department of Orthopedic Surgery and Traumatology, Military Hospital Mohammed V (HMIMV), Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco

^&Corresponding author
Naoufal Elghoul, Department of Orthopedic Surgery and Traumatology, Military Hospital Mohammed V (HMIMV), Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Morocco

Image in medicine    

A-35-years old man, with no history of trauma, presented pain and total impotence of the small finger following a match of basketball. The patient was transferred to our emergency department in about thirteen minutes. On admission, he was stable with no distress signs. The uninjured limb held the injured limb, and we noted a deformation at the level of the interphalangeal joint of the small finger. Palpation and mobilization of the finger were painful. The neurovascular exam was normal. The radiograph of the hand (lateral and anterior-posterior views) was realized that showed a rotatory volar dislocation of the proximal phalangeal joint with no fracture. Under digital block anesthesia, a combined slight flexion and axial traction of the phalanx were applied, after which the reduction was obtained, and it remained stable. The control radiograph confirmed the reduction. Then, a splint immobilized both proximal and distal interphalangeal joints in a neutral position along with buddy taping of the injured digit to the uninjured digit adjacent for 6 weeks. At this period, there was no instability of the collateral ligaments on exposure to passive stress after which active exercises were started. Evaluation at 6 months found that the active range of movement of the proximal interphalangeal joint was from 0^o extension to 90^o flexion, with no pain no recurrence of dislocation and he had returned to his full activities.

Figure    

Figure 1: (A) the clinical aspect of the rotatory volar dislocation of the proximal interphalangeal joint of the small finger; (B) anterior-posterior and; (C) lateral X-rays showed the dislocation of the proximal interphalangeal joint; (D) control radiograph after reduction of the dislocation (arrow)