title: Proximal interphalangeal joint dislocations and treatment: an evolutionary process.
abstract: BACKGROUND
  Proximal interphalangeal joint (PIPJ) dislocations represent a significant proportion of hand clinic visits and typically require frequent follow-ups for clinical assessment, orthotic adjustments, and physiotherapy. There are a large number of treatment options available for PIPJ dislocations, yet no prospective or controlled studies have been carried out, largely due to the diversity of the various types of injuries.
  
  
  METHODS
  We retrospectively reviewed all the PIPJ dislocations in our institution over a five-year period and directly compared the different splinting techniques that we have used over this time frame.
  
  
  RESULTS
  There were a total of 77 dislocations of the PIPJ (57 men and 20 women) that were included in our study. We found that our management has shifted gradually from complete immobilisation to controlled early mobilisation with figure-of-eight splints. Following treatment, the range of motion of the PIPJ in the figure-of-eight group was significantly greater than that in the other three methods (P<0.05) used. There were significantly fewer hospital visits in the figure-of-eight splint group than in the other treatment groups.
  
  
  CONCLUSIONS
  The treatment of PIPJ dislocations has undergone a significant evolution in our experience. Early controlled mobilisation has become increasingly important, and therefore, splints have had to be adapted to allow for this. The figure-of-eight splint has yielded excellent results in our experience. It should be considered for all PIPJ dislocations, but careful patient selection is required to achieve optimum results.
authors: Department of Plastic and Reconstructive Surgery, Galway University Hospital, Galway, Ireland.
authors: Kenneth Michael
authors: KM
authors: Joyce
authors: Department of Plastic and Reconstructive Surgery, Galway University Hospital, Galway, Ireland.
authors: Cormac Weekes
authors: CW
authors: Joyce
authors: Department of Plastic and Reconstructive Surgery, St. Vincent's University Hospital, Dublin, Ireland.
authors: Frank
authors: F
authors: Conroy
authors: Department of Plastic and Reconstructive Surgery, Galway University Hospital, Galway, Ireland.
authors: Jeff
authors: J
authors: Chan
authors: Department of Plastic and Reconstructive Surgery, St. Vincent's University Hospital, Dublin, Ireland.
authors: Emily
authors: E
authors: Buckley
authors: Department of Plastic and Reconstructive Surgery, St. Vincent's University Hospital, Dublin, Ireland.
authors: Sean Michael
authors: SM
authors: Carroll
keywords: Dislocation; Finger joint; Splint