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A WORD ABOUT JOINT DISLOCATIONS..<br />
PIPJ: dorsal dislocation; hyperex.+longitudinal compression<br />
Simplecomplex fracture-dislocation (most unstable)<br />
Simple & complex- immobilization 3-4w<br />
Fracture-dislocation (volar plate tear)- immobilization or<br />
K-wire or even open reduction (volar plate arthroplasty)<br />
Lateral dislocation; collat. Lig. rupture & volar plate tear<br />
small rupture – body taping 4-6w; major- surgical repair<br />
Volar dislocation; rare; unstable; extensive trauma, central slip disruption<br />
Central slip repair + immobilization;<br />
Boutonierre deformity sequela<br />
DIPJ: open dislocation is more common (cutaneous anchoring to bone<br />
Debridement, reduction, splinting. Antibiotics; if closed- reduced & stable<br />
A WORD ABOUT JOINT DISLOCATIONS..<br />
MCPJ: dorsal dislocation; forced hyperextension<br />
Simple- reduction by wrist flex. & MCPJ tract. + flex.<br />
Early active motion<br />
Complex- prominence in palm & skin dimpling<br />
Rx: intra articular sesamoid bone (volar plate)<br />
Open redcution (dorsal approach)<br />
Lateral dislocation; forceful adduction / abduction; may not be noticed<br />
Partial tear- buddy taping protection 3w<br />
Complete tear- surgical repair<br />
CMCJ: axial loading<br />
If acute – easy reduction; pinning to maitain reduction<br />
Failure – pain, weakness,degenerative arthritis
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