Distal interphalangeal dislocation (finger)

Revision as of 17:34, 14 December 2022 by Rossdonaldson1 (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)


Distal interphalangeal dislocation (DIP), proximal interphalangeal dislocation (PIP), and metacarpophalangeal dislocation (MCP) joints of the finger shown.
Volar/anterior finger anatomy.
Lateral finger anatomy.
  • Uncommon due to firm attachment of skin and subcutaneous tissue to underlying bone
  • Usually dorsal dislocation

Hand Anatomy

  • Volar = anterior = dorsal
  • Dorsal = posterior = palmar

Clinical Features

  • Finger pain/deformity at DIP joint

Differential Diagnosis

Distal Finger (Including Nail) Injury

Hand and finger dislocations


  • Finger x-ray (PA and lateral)
    • True lateral of only the finger instead of hand will help detect subtle avulsion fractures [1]



  • Flex wrist, then hyperextend the joint
  • Apply longitudinal traction followed by dorsal pressure to phalanx base
  • Irreducible dislocation likely due to entrapment of avulsion fracture, profundus tendor or volar plate
    • Without initial hyperextension, can be difficult to disengage from any trapped soft tissue
  • Post reduction, look for central slip rupture, which may lead to Boutonniere deformity


  • Flex wrist then hyperflex the affected joint
  • Apply gentle traction then extend the joint
  • Often need open reduction due to volar plate entrapment


  • Alumifoam splint on side of dislocation
  • 10-20 degrees of flexion for dorsal dislocation, joint in extension for volar dislocation
  • Splint should not extend onto the palm


  • If closed dislocation and successfully reduced → Discharge with hand surgery follow-up
  • If open or unable to be reduced in ED → hand surgery consult, likely admission

See Also

External Links


  1. Horn A. Management of Common Dislocations. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014.