Management of proximal interphalangeal joint injuries

Injuries to the proximal interphalangeal joint are common but frequently missed. They are often overtreated by prolonged immobilization, resulting in stiffness, which may be permanent. The purpose of the present article is to briefly review the relevant anatomy and biomechanics, present an approach to physical examination and diagnosis, and propose a practical clinical classification. The treatment of the most severe injury - the intra-articular fracture dislocation - is controversial. The various treatment options are discussed, based on personal experience and a review of the literature. A list of relevant references is presented.