From the Research
The treatment plan for a proximal interphalangeal (PIP) joint dislocation after reduction should prioritize early controlled mobilization with a figure-of-eight splint to achieve the best outcomes in terms of range of motion and minimizing hospital visits, as evidenced by the most recent and highest quality study 1.
Key Components of Treatment Plan
- Immobilization in slight flexion (approximately 20-30 degrees) using a figure-of-eight splint for 1-2 weeks to protect the healing collateral ligaments
- Early protected motion to prevent stiffness, starting with active range-of-motion exercises 3-4 times daily while continuing to use the splint between exercise sessions
- Controlled mobilization phase lasting an additional 2-3 weeks
- Gradual discontinuation of the splint as pain and swelling subside, usually by 3-4 weeks post-reduction
- Full recovery typically takes 6-8 weeks, though mild swelling and stiffness may persist longer
Rationale
The figure-of-eight splint allows for controlled early mobilization, which has been shown to yield excellent results in terms of range of motion and minimizing hospital visits 1. This approach balances the need to protect the healing collateral ligaments while preventing joint stiffness, a common complication of prolonged immobilization of finger joints. While other studies have investigated various treatment modalities, including surgical management 2, the use of a figure-of-eight splint for early controlled mobilization is supported by the most recent and highest quality evidence 1.
Additional Considerations
- Ice application and elevation of the hand above heart level can help reduce swelling during the initial immobilization period
- Oral analgesics such as acetaminophen or ibuprofen can be used for pain management
- Patient selection and careful monitoring are crucial to achieving optimum results with the figure-of-eight splint 1