Which medical history is characteristic of volar PIP joint dislocations?

Updated: Jan 18, 2018
  • Author: Jay E Bowen, DO; Chief Editor: Craig C Young, MD  more...
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Answer

Volar PIP joint dislocations

  • Volar dislocations of the PIP joint are less common than dorsal dislocations and are more difficult to manage than other injuries. A volar dislocation ruptures the extensor mechanism, possibly involving injury of the central slip.

  • Evaluation of the PIP joint injury starts with the history to understand the mechanism and direction of injury, the presence of an initial deformity, and whether a reduction was performed. The physical examination includes thorough inspection and palpation of the area and localization of the tenderness. The examination should also include testing active and passive range of motion, with and without resistance. Tenderness dorsally indicates a central slip injury. This is confirmed if there is pain and inability to extend the PIP joint against resistance. Lateral stressing of the joint assesses integrity of the collateral ligaments and the degree of instability.


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