Skip to main content
SpringerLink
Log in

Dorsal Block Splinting for Dorsal Fracture-Dislocations

  • Chapter
  • First Online:
PIP Joint Fracture Dislocations

  • 753 Accesses

Abstract

There are a variety of treatment options for dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint. Extension block splinting is a form of nonoperative management that focuses on maintaining an acceptable reduction of the PIP joint while allowing for adequate, safe motion. By maintaining a reduced joint, the extension block orthosis allows the ligamentous structures surrounding the PIP joint to heal in their anatomic locations. The risk of developing a flexion contracture, which is high with any PIP joint injury, is minimized with the use of an extension block orthosis because of its ability to allow early active motion of the PIP joint while controlling PIPJ flexion. This chapter describes a clinical case utilizing extension block splinting for a dorsal fracture-dislocation of the PIP joint.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Green DP. Green’s operative hand surgery. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005.

    Google Scholar 

  2. Elfar J, Mann T. Fracture-dislocations of the proximal interphalangeal joint. J Am Acad Orthop Surg. 2013;21:88–98. doi:10.5435/JAAOS-21-02-88.

    Article  PubMed  Google Scholar 

  3. Strickland JW, Steichen JB, American Society for Surgery of the Hand. Difficult problems in hand surgery. St. Louis, MO: Mosby; 1982. xiii, 434.

    Google Scholar 

  4. Kiefhaber TR. Phalangeal dislocations/periarticular trauma. New York, NY: McGraw-Hill Professional Publishing; 1996.

    Google Scholar 

  5. Hastings 2nd H, Carroll 4th C. Treatment of closed articular fractures of the metacarpophalangeal and proximal interphalangeal joints. Hand Clin. 1988;4:503–27.

    PubMed  Google Scholar 

  6. McAuliffe JA. Dorsal fracture dislocation of the proximal interphalangeal joint. J Hand Surg [Am]. 2008;33:1885–8. doi:10.1016/j.jhsa.2008.08.017.

    Article  Google Scholar 

  7. McElfresh EC, Dobyns JH, O’Brien ET. Management of fracture-dislocation of the proximal interphalangeal joints by extension-block splinting. J Bone Joint Surg Am. 1972;54:1705–11.

    CAS  PubMed  Google Scholar 

  8. Phair IC, Quinton DN, Allen MJ. The conservative management of volar avulsion fractures of the P.I.P. joint. J Hand Surg (Br). 1989;14:168–70. doi:10.1016/0266-7681(89)90120-4.

    Article  CAS  Google Scholar 

  9. Hamer DW, Quinton DN. Dorsal fracture subluxation of the proximal interphalangeal joints treated by extension block splintage. J Hand Surg (Br). 1992;17:586–90. doi:10.1016/S0266-7681(05)80249-9.

    Article  CAS  Google Scholar 

  10. Arora R, Lutz M, Fritz D, Zimmermann R, Gabl M, Pechlaner S. Dorsolateral dislocation of the proximal interphalangeal joint: closed reduction and early active motion or static splinting; a retrospective study. Arch Orthop Trauma Surg. 2004;124:486–8. doi:10.1007/s00402-004-0707-0.

    Article  CAS  PubMed  Google Scholar 

  11. Newington DP, Davis TR, Barton NJ. The treatment of dorsal fracture-dislocation of the proximal interphalangeal joint by closed reduction and Kirschner wire fixation: a 16-year follow up. J Hand Surg (Br). 2001;26:537–40. doi:10.1054/jhsb.2001.0698.

    Article  CAS  Google Scholar 

  12. Duteille F, Pasquier P, Lim A, Dautel G. Treatment of complex interphalangeal joint fractures with dynamic external traction: a series of 20 cases. Plast Reconstr Surg. 2003;111:1623–9. doi:10.1097/01.PRS.0000054160.46502.D0.

    Article  PubMed  Google Scholar 

  13. Majumder S, Peck F, Watson JS, Lees VC. Lessons learned from the management of complex intra-articular fractures at the base of the middle phalanges of fingers. J Hand Surg (Br). 2003;28:559–65. doi:10.1016/S0266-7681(03)00139-6.

    Article  CAS  Google Scholar 

  14. Dionysian E, Eaton RG. The long-term outcome of volar plate arthroplasty of the proximal interphalangeal joint. J Hand Surg [Am]. 2000;25:429–37. doi:10.1016/S0363-5023(00)70026-8.

    Article  CAS  Google Scholar 

  15. Kuczynski K. The proximal interphalangeal joint. Anatomy and causes of stiffness in the fingers. J Bone Joint Surg (Br). 1968;50:656–63.

    CAS  Google Scholar 

  16. Lutz M, Fritz D, Arora R, Kathrein A, Gabl M, Pechlaner S, Del Frari B, Poisel S. Anatomical basis for functional treatment of dorsolateral dislocation of the proximal interphalangeal joint. Clin Anat. 2004;17:303–7. doi:10.1002/ca.10216.

    Article  CAS  PubMed  Google Scholar 

  17. Deitch MA, Kiefhaber TR, Comisar BR, Stern PJ. Dorsal fracture dislocations of the proximal interphalangeal joint: surgical complications and long-term results. J Hand Surg [Am]. 1999;24:914–23. doi:10.1053/jhsu.1999.0914.

    Article  CAS  Google Scholar 

  18. Salter RB, Simmonds DF, Malcolm BW, Rumble EJ, MacMichael D, Clements ND. The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage. An experimental investigation in the rabbit. J Bone Joint Surg Am. 1980;62:1232–51.

    CAS  PubMed  Google Scholar 

  19. Howell JW, Merritt WH, Robinson SJ. Immediate controlled active motion following zone 4-7 extensor tendon repair. J Hand Ther. 2005;18:182–90. doi:10.1197/j.jht.2005.02.011.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, UPMC Hamot, 201 State Street, Erie, PA, 16550, USA

    C. Liam Dwyer M.D., Scott W. Rogers M.D., Alex J. Ferikes M.D. & John D. Lubahn M.D.

  2. Hand and Upper Body Rehabilitation Center, 300 State Street, Erie, PA, 16507, USA

    Terri L. Wolfe O.T.R./L., C.H.T. & Katie Froehlich O.T.R./L., C.H.T.

Authors
  1. C. Liam Dwyer M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Scott W. Rogers M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alex J. Ferikes M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John D. Lubahn M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Terri L. Wolfe O.T.R./L., C.H.T.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katie Froehlich O.T.R./L., C.H.T.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Terri L. Wolfe O.T.R./L., C.H.T. .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Minneapolis, Minnesota, USA

    Julie E. Adams

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Dwyer, C.L., Rogers, S.W., Ferikes, A.J., Lubahn, J.D., Wolfe, T.L., Froehlich, K. (2016). Dorsal Block Splinting for Dorsal Fracture-Dislocations. In: Adams, J. (eds) PIP Joint Fracture Dislocations. Springer, Cham. https://doi.org/10.1007/978-3-319-28579-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-28579-5_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28577-1

  • Online ISBN: 978-3-319-28579-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation