Journal Contents   |    
Anterior Dislocation of the Proximal Interphalangeal Joint A CAUSE OF RUPTURE OF THE CENTRAL SLIP OF THE EXTENSOR MECHANISM
View Disclosures and Other Information
From the Combined Hand Service (Orthopedic, Plastic and General Surgery), The Albert Einstein College of Medicine, New York, and the Departments of Orthopedic and Hand Surgery, Brookdale Hospital Center, Brooklyn
1970 by The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 1970 Oct 01;52(7):1329-1336
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


Five acute and chronic dislocations of the proximal interphalangeal joint were observed. All were associated with ruptures of the central slip of the extensor mechanism as shown by surgical exploration or the appearance of a boutonnière deformity after treatment. A study of the pathomechanics of this lesion in thirty fresh cadaver fingers indicated that the lesion is produced by a combination of a varus or valgus force and an anteriorly directed force on the base of the middle phalanx. Avulsion of collateral ligament, a tear of the volar plate, and rupture of the central slip are associated with the dislocation. Based on these findings and our experience with two surgically treated dislocations, procedures for the treatment of acute and chronic dislocations are proposed. The acute lesion should be treated by open reduction, fixation of the proximal interphalangeal joint in full extension with a transfixing Kirschner wire, and repair of the torn central slip, collateral ligament, and volar plate. The chronic lesion should also be reduced and fixed with a transfixing wire. However the volar plate must be excised before reduction is possible. The central slip and collateral ligaments must then be reconsitituted.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Results provided by:
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    Illinois - Hinsdale Orthopaedics
    Connecticut - Yale University School of Medicine
    Oregon - The Center - Orthopedic and Neurosurgical Care and Research