Abstract

Simultaneous dislocation of the proximal and distal interphalangeal joints of one finger is a rare lesion first described by Bartels in 1874. We report 3 cases in 3 athletes. The fingers affected were the little finger in 2 patients and the index finger in one. The dominant hand was involved in 2 cases. Treatment was orthopaedic in all 3 patients and consisted of emergency reduction under plexus anaesthesia and immobilization during 3 weeks, with the metacarpophalangeal joints at 90 degrees and the proximal and distal interphalangeal joints in extension, followed by rehabilitation. The maximum follow-up period was 6 months. Very good results were obtained in 2 patients; the third one had rupture of the deep flexor muscle tendon which was revealed after 2 months and well tolerated. A review of the literature yielded 30 cases. The lesion occurs predominantly in men, and its mechanism is a direct axial blow on the third phalanx during a sport accident (chiefly volley-ball), with a predilection for the 4th and 5th fingers of the dominant hand, which are less protected than the other fingers. Treatment is almost invariably orthopaedic. Surgery is performed only in cases with joint instability or when a large bone fragment is present. Verf.-Referat