Dorsal fracture subluxation of the proximal interphalangeal joints treated by extension block splintage.

In a prospective study, 27 consecutive patients with dorsal fracture subluxation of the PIP joint were treated conservatively using an extension block splint, with good results in 70%. The percentage surface involved with the fracture varied considerably (19-77%) the average being 55%. Three patients initially managed with splintage proceeded to surgery because the splint failed to hold the joint in reduction. These patients had a less favourable outcome. We feel that all such fractures can be treated by splintage, provided that early reduction is maintained in the splint and checked by serial radiology.