A 13 year old female presents with right 5th digit pain and deformity after she hyperextended her finger while catching a basketball. What's the diagnosis? (scroll down for answer)

Answer: Proximal interphalangeal joint dislocation

Mechanism - hyperextension or axial load

-Usually ulnar deviation as radial collateral ligament more likely to rupture (as in this case)

-May be dorsal (associated with volar plate rupture, can lead to Swan neck deformity) or ventral​

Management:

-Perform thorough neuromuscular exam 

-Reduce digit - usually digital block sufficient for pain control

-Test ROM and strength following reduction —> if normal can splint in 30 degrees of flexion for 3 weeks (or in extension if volar dislocation)

-Needs operative repair only If irreducible or evidence of complete ligamentous disruption

References: 

Long, B, Koyfman, A. “Injuries to the Hand and Digits.” Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8th Ed. Judith E. Tintinalli, el al. New York, NY: McGraw-Hill, 2016