Hand Injuries

Baseball Finger
Brachial Plexus Injuries
Carpal Avascular Necrosis
Flexor / Extensor Tendon Injuries
Nerve Injuries
Proximal Interphalangeal (PIP) Joint Injury
Ulnar Collateral Ligament (UCL) of the Thumb


Proximal Interphalangeal (PIP) Joint Injury

The proximal interphalangeal (PIP) joint is the finger joint closest to the knuckle, or metacarpophalangeal (MCP) joint. With the help of ligaments, the PIP joint is one of two interphalangeal (IP) joints responsible for connecting the three phalanges of the finger.

Hands are vulnerable to injury because of the role they play in sports and everyday activity. Injury to the PIP joint is one of the most common injuries the hand sustains and can occur as a sprain or a complete tear of the ligament - resultant of an activity that causes the joint to hyperextend - as well as a dislocation.

A sprain represents a ligament that has been stretched and partially torn. A complete tear represents a ligament that has ruptured or torn completely away from its attachment to the middle phalanx. Occasionally, there is also a small bone fragment that pulls away as well. This is called an avulsion. A dislocation occurs when the middle phalanx is pushed behind the proximal phalanx.

Sometimes the pain from a sprain is subtle, which can delay diagnosis and cause more severe problems. Though symptoms associated with a ligament tear may cause great discomfort. There may be pain and swelling. And a complete dislocation will cause an obvious deformity.

Risk Factors
PIP injuries are common injuries in throwing and catching sports, where the hands are frequently vulnerable to excessive force. They may also occur in falling or automobile accidents.

Diagnosis and Treatment
Description of the manner in which the injury occurred and a physical examination are generally all that is necessary in diagnosing a PIP injury. An x-ray will confirm physical findings. Treatment will vary depending on the severity of the injury.

Conservative, or nonsurgical, treatment may consist of short-term splinting and rehabilitative exercises in order to avoid stiffness within this sensitive joint. Steps are also taken to reduce swelling, which can cause permanent stiffness. Brief periods of immobilization, early range of motion exercises and day-to-day movement are key to restoring full function to this particular joint.

More severe injuries may require surgery to repair the damage and perform realignment. If PIP injuries are not addressed properly an environment of instability will quickly deteriorate the joint environment.

In severe cases of instability and joint deterioration, PIP joint replacement may be required.