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Simple
dorsal phalangeal dislocations
Dorsal dislocations of the metacarpophalangeal, proximal interphalangeal, or distal interphalangeal joints follow a hyperextension injury, and are "simple" only because reduction is usually straightforward: block anesthesia; irrigate and cleanse any open injuries; radiographs; stress the joint in the direction which produced the injury to open the internal path for relocation; gentle progressive pressure on the base of the dislocated bone; "pop" - the joint is reduced; confirmatory radiographs. This is a typical scenario, and most often involves the proximal interphalangeal joint. Not all dislocations are easily reduced. If an attempt at closed reduction under anesthesia is unsuccessful, the patient should be considered a candidate for open reduction rather than aggravating injury with repeated attempts at closed reduction.
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