56-year-old female with history of fifth PIP joint subluxation status post ORIF. Assess volar plate. There is post traumatic deformity of the fifth middle phalanx as seen on recent radiographs. The majority of the middle phalanx is subluxed/dislocated volarly with respect to the proximal phalanx. A bandlike structure extending from the head of the proximal phalanx to the volar aspect of the base of the middle phalanx likely represents the volar plate and appears grossly intact. Mild deformity of and edema within the middle phalanx are compatible with healing fracture. Edema is also noted within the head, neck, and diaphysis of the proximal phalanx and may also be post-traumatic in etiology. A small bony fragment situated posterior to the base of the middle phalanx and distal to the head of the proximal phalanx is consistent with an ununited fracture fragment as seen on recent radiographs. The central slip of the extensor tendon appears to extend to this bony fragment. The lateral slips of the extensor tendon extend to the base of the fifth distal phalanx as expected. The flexor tendon apparatus appears intact, with a small amount of fluid in the flexor tendon sheath volar to the 5th metacarpal. The A2 pulley appears intact on transverse images; however, we cannot comment on the integrity of the C1 and A3 pulleys. Evaluation of the collateral ligaments is limited secondary to post-traumatic deformity of the joint and adjacent edema.
Fracture and subluxation/dislocation of the fifth PIP joint as described above, with what appears to be an intact volar plate.