Volar dislocation of the proximal interphalangeal (pip) joint is an uncommon injury. Typically, one condylar head of the proximal phalanx perforates the extensor mechanism, thus becoming entrapped in a ‘buttonhole’. Closed reduction is frequently unsuccessful due to the presence of extensor mechanism trapped within the joint, necessitating surgical reduction. This case report describes an irreducible volar pip joint dislocation, which required open reduction. At operation, the classic pathologic disruption was identified and repaired.
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