When you sustain a PIP joint dislocation, the volar rim of the middle phalanx--P-2--may fracture. If it is a small percentage of the bone, on the lateral xray, early range of motion with the use of a splint to limit extension, may be an option----since the collateral ligaments are still attached to the base of P-2. However, if the joint is unstable because of the size of the bone piece, BUT if the piece is less than 40-50% of the joint surface, "volar plate arthroplasty" becomes an attractive option. The long-term success has been championed in the literature by Dr Eaton in NYC--clearly showing the liklihood that functional range of motion and PIP joint stability can be restored. The procedure resurfaces the base of P-2 with volar plate--attached at the location of the volar rim fracture. Motion of the PIP joint begins at 3 weeks after surgery.Final flexion usually approximates 80 degrees; a slight flexion contracture is common, however.

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