Irreducible Proximal Interphalangeal Joint Dislocation Associated with Volar Plate Buttonholing: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Aim:Proximal interphalangeal (PIP) joint dislocations are common hand injuries, often complicated by volar plate (VP) interposition, which may prevent closed reduction. This study aims to present a rare case of irreducible dorsal PIP dislocation with complete distal and proximal VP separation and to discuss surgical management using mini-suture anchors.Case:A 40-year-old male sustained a dorsal PIP dislocation of the third finger of his left hand following a non-vehicular traffic accident. Closed reduction attempts failed. Radiographs and magnetic resonance imaging revealed no bony pathology, but VP interposition within the joint space was suspected. Open reduction was planned via a volar Bruner incision under regional anesthesia.Results:Intraoperatively, the VP was trapped between the proximal and middle phalanges, creating a button-holing mechanism. Anatomical repair was performed using mini-suture anchors at both distal and proximal VP insertions to restore axial stability. Early active mobilization with a dorsal extension block splint was initiated postoperatively. At the eighth-week follow-up, the patient achieved 100° of active PIP motion. According to American Society for Surgery of the Hand (ASSH) criteria, total active motion was 230°, and the palm-to-fingertip distance was 0 cm. No complications were reported, and the patient returned to work.Conclusion:Irreducible PIP dislocations may result from intra-articular interposition of soft tissue structures, particularly the VP. Complete distal and proximal VP detachment, though rare, can create a mechanical block preventing closed reduction. Anatomical repair using mini-suture anchors offers stable fixation, permits early rehabilitation, and provides satisfactory functional outcomes. This technique is recommended as a safe and effective surgical option for complex PIP dislocations with VP involvement.Keywords: interphalangeal joint; joint dislocation; volar plate; suture anchors; treatment outcome
Source: İzmir Tıp Fakültesi Dergisi
Author: Yavuz Önel
Institution: İzmir Şehir Hastanesi
Language: Turkish
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7214885518