What are treatment options for DIP joint dislocations?

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

If the dislocation is closed, it should be reduced after anesthetizing the digit by applying longitudinal traction. After reduction, the joint should be evaluated for tendon and ligament injuries. They can be irreducible when a condyle of the middle phalanx becomes buttonholed between a collateral ligament and the volar plate.

Treatment consists of digital block anesthesia followed by one gentle attempt at closed reduction by hyperextending the distal phalanx and then sliding the base of the distal phalanx over the head of the proximal phalanx. Rotational force may be necessary. If unsuccessful, open reduction is required.

Open DIP joint dislocations require surgical wound care and reduction to prevent bone or joint infections, even if there is only a small break in the volar skin. Otherwise, the distal joint is splinted in full extension for 1-2 weeks. Active range of motion is begun at 2-3 weeks, and a splint is worn until full, pain-free range of motion is achieved. If the athlete continues to play sports, the DIP joint should be splinted for 4-6 weeks to prevent reinjury.


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