Reduction of volar dislocations is achieved through slackening the extensors by slightly extending the wrist and flexing the metatarsophalangeal and PIP joints to take tension off the lateral bands. A rotation maneuver is then used to achieve reduction. If this fails, open reduction is required. A complete extensor tendon rupture may accompany this injury and cause late deformity. It allows motion through a stable range of flexion while blocking the portion of extension in which the fracture is unstable and dislocates.
Unstable injuries require surgery.
Awareness of potential problems related to PIP joint injuries can help clinicians achieve good results. Fracture-dislocations of the PIP joint may be prone to redislocation. Mallet Finger Anatomy. This is thought to be a relatively avascular area of the tendon, which may account for its rupture in some cases. Types of injury.