The proximal interphalangeal joint (PIPJ) is the most frequently injured joint in the hand and is also responsible for approximately 85% of the motion for functional grip. 1 Injuries to this joint, particularly complex injuries such as dorsal fracture-dislocations (DFDs), can result in significant morbidity. 2 Understanding the aetiology of DFDs of this joint is important for management and risk reduction.
A retrospective analysis of all unstable DFDs of the finger PIPJs treated with osteochondral grafts at a single institution over a ten-year period was conducted. Demographic data and details of the mechanism and extent of the injury were collected. Patients with incomplete data sets were excluded from the analysis. Ethics approval was obtained.
Forty-three patients met inclusion criteria and six patients were excluded. The average age was 31 years, with male predominance (83% male). The most injured digit was the ring finger. The right hand was injured more frequently than the left (65%), with the dominant hand injured in 58% of patients.
The mechanism of injury was most commonly cricket (37%), followed by Australian Rules Football (AFL) (30%). Index finger injuries were almost entirely attributed to cricket (80%).
Specific aetiology of DFDs is scarcely reported in the literature. Ball sports (cricket and AFL) were the most common mechanism of injury in our study cohort, supporting others findings. 3
Index finger DFDs much less commonly occur in comparison to other digits and were almost entirely due to cricket.
Young men participating in ball sports, particularly cricket and AFL, represent a disproportionate number of PIPJ DFDs within Australia. Early recognition and instigation of referral to a hand surgeon and appropriate management of these injuries will improve outcomes for patients.