PALMER FRACTURE-DISLOCATION OF THE PROXIMAL INTERPHALANGEAL JOINT

Palmar fracture dislocation of the proximal interphalangeal joint is u ncommon. Thirteen patients treated for this injury were retrospectivel y reviewed. There were 9 acute injuries. Seven were treated by closed reduction and percutaneous pin fixation and 2 were treated by open red uction and internal fixation. The 4 chronic injuries (more than 1 mont h after injury) were treated with open reduction and soft tissue recon struction. The length of follow-up averaged 55 months. Eight patients were free from pain. Postoperative proximal interphalangeal motion ave raged 91 degrees for the acute injuries and 70 degrees for the chronic injuries. Follow-up radiographic findings were notable for an increas ed height of the middle phalangeal base in 6 patients, articular irreg ularity in it, and residual subluxation in 2; however, these changes d id not correlate with the clinical results. Complications included los s of reduction in 1 patient, progressive swan neck deformity in II and development of an average 25 degrees extension lag of the distal inte rphalangeal joint in 5. Copyright (C) 1998 by the American Society for Surgery of the Hand.