# Neglected Dorsal Proximal Interphalangeal Joint Dislocation Treated by Volar Plate Arthroplasty: A Case Series

## TL;DR

This paper presents six cases of long-unreduced hand joint dislocations successfully treated with a specific surgical method.

## Contribution

The study contributes a case series demonstrating volar plate arthroplasty's effectiveness for neglected dorsal PIP joint dislocations.

## Key findings

- Volar plate arthroplasty with extension block pinning achieved functional joint stability in six neglected cases.
- Success required preserved articular cartilage and less than 30% bone loss.
- Literature highlights the rarity and complexity of managing chronic unreduced PIP joint dislocations.

## Abstract

Chronic unreduced dislocations of the proximal interphalangeal joint are uncommon, and management principles for these injuries have not been defined. The dislocation can be volar or dorsal and closed reduction is rarely successful owing to soft tissue contractures. Treatment options in literature reviews for such rare injuries included open reduction of pip joint with volar plate arthroplasty, extension block pinning, hemi hamate arthroplasty, pip joint arthrodesis, Suzuki dynamic frame fixation, open reduction and repair of capsule and collateral ligaments with suture anchors. Few cases of amputation following treatment were even reported in literature emphasizing the role of meticulous soft tissue handling in such neglected cases of hand. We report six cases of neglected (more than three months old) dorsal dislocation of the PIP joint of the hand, treated with volar plate arthroplasty and extension block pinning. A functional range of motion with a stable joint can be achieved in such injuries with volar plate arthroplasty, as long as the articular cartilage is relatively preserved and bone loss is <30%.