The thumb IP joint is a simple hinge joint with a single degree of freedom allowing the thumb tip to flex and extend for pinching activities. Its collateral ligaments are tight in extension and lax in flexion — opposite to the MCP joints — requiring testing in the extended position for instability assessment. Gamekeeper thumb typically involves the MCP UCL rather than the IP joint.
Interphalangeal joint dislocation of the thumb from hyperextension injury requires reduction followed by buddy tape or splinting. Seymour fractures in children involve the distal phalanx physis with open nail bed injury at the IP joint level and must be treated as open fractures requiring irrigation and fixation.
Dorsal IP dislocation from hyperextension requiring closed reduction and splinting for 2 to 3 weeks.
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