Coach' s Finger

Named for injuries to baseball coaches, this term refers a dorsal dislocation of one of the proximal interphalangeal joints. Care must be made to determine if there is an associated volar plate fracture. With dorsal dislocations, the volar plate is usually detached from the middle phalanx. These injuries are due to hyperextension (such as from catching a ball). These injuries are usually managed nonoperatively, but if the collateral ligaments are disrupted, the joint will become unstable and arthroplasty will be required.
A PA radiograph of the hand. The second PIP joint is slightly overriding.

B Coned AP radiograph of the second digit. Again, the PIP joint is overriding.

C Lateral radiograph of the second digit. There is dorsal dislocation of the PIP joint. This case is unusual in that there is not an associated volar plate fracture because this is an open injury (notice the air).

Links to online textbooks

Wheeless' Orthopedics: discussion of proximal interphalangeal joint dislocations

References:

Deitch MA, Kiefhaber TR, Comisar BR, Stern PJ: Dorsal fracture dislocations of the proximal interphalangeal joint: surgical complications and long-term results J Hand Surg [Am]. 1999 Sep;24(5):914-23. [See related articles]
Waldron VD: Treatment of displaced fractures of the PIP joint Am J Orthop. 1999 Mar;28(3):152. [See related articles]

A	PA radiograph of the hand. The second PIP joint is slightly overriding.
B	Coned AP radiograph of the second digit. Again, the PIP joint is overriding.
C	Lateral radiograph of the second digit. There is dorsal dislocation of the PIP joint. This case is unusual in that there is not an associated volar plate fracture because this is an open injury (notice the air).