Presentation
Deformed finger following a motor bike accident.
Patient Data
The proximal interphalangeal joint of the middle finger is dislocated, with the middle phalanx lying dorsal and lateral to the proximal phalanx. A small sliver of bone is seen on the palmar aspect of the head of the proximal phalanx consistent with a small avulsion fracture. The head of the proximal phalanx appears to project through the skin, consistent with an open injury.
Avulsion fracture (blue arrow) from the base of the middle phalanx is noted, involving only a small amount of the articular surface (yellow arrow). The head of the proximal phalanx appears to project through the soft tissues of the volar aspect of the finger (red arrow) with air seen in the soft tissues on AP projection (green arrow).
Case Discussion
Typical appearances of an interphalangeal joint dislocation with an associated small volar avulsion fracture. Protrusion of the phalanx through the skin is unusual and is in keeping with the high impact mechanism of the injury.
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