Case Report: Bridge Plating for Unstable PIP Fracture Dislocation

Proximal interphalangeal (PIP) fracture-dislocation is a relatively common injury that results from “jamming” a finger.Treatment hinges on the degree of articular surface involvement, which determines stability of the joint. For unstableinjuries, a variety of surgical interventions have been described including extension block pinning, open reduction internalfixation, volar plate arthroplasty, static or dynamic external fixation, and hemi-hamate reconstruction. We present thecase of an unstable, subacute ring finger PIP dorsal fracture dislocation for which the above options were not possible ordesirable to the patient.We performed temporary bridge plate fixation of the joint, based on the success of a similar procedure used to treatcomminuted and unstable distal radius fractures.The procedure allowed immediate return to work, which was the patients’ primary goal, and resulted in a reasonable shorttermoutcome, similar to other mentioned procedures.Temporary bridge plate fixation can be considered among treatment choices for PIP fracture dislocation when other, moreestablished options are not possible or desirable.Level of evidence: IV