Case Report: Bridge Plating for Unstable PIP Fracture Dislocation.

Abstract

Proximal interphalangeal (PIP) fracture-dislocation is a relatively common injury that results from "jamming" a finger. Treatment hinges on the degree of articular surface involvement, which determines stability of the joint. For unstable injuries, a variety of surgical interventions have been described including extension block pinning, open reduction internal fixation, volar plate arthroplasty, static or dynamic external fixation, and hemi-hamate reconstruction. We present the case of an unstable, subacute ring finger PIP dorsal fracture dislocation for which the above options were not possible or desirable to the patient. We performed temporary bridge plate fixation of the joint, based on the success of a similar procedure used to treat comminuted and unstable distal radius fractures. The procedure allowed immediate return to work, which was the patients' primary goal, and resulted in a reasonable short-term outcome, similar to other mentioned procedures. Temporary bridge plate fixation can be considered among treatment choices for PIP fracture dislocation when other, more established options are not possible or desirable.