The proximal interphalangeal joint is commonly injured in vigorous sports, but often the severity of the injury is not appreciated and the onset of treatment delayed for weeks or months. In an eight-year period, 143 athletic injuries to the proximal interphalangeal joint required surgery; these cases are reviewed. The anatomy of the joint, the indications for surgery, the details of operative technique and postoperative management, and the results are discussed in the various clinical categories of injury to the joint: articular fractures, fracture-dislocations, compound dislocations, collateral-ligament ruptures, boutonnière deformities, hyperextension deformities, and pseudo-boutonnière deformities.

Early surgical repair of the injuries gives good results in those young athletes who are cooperative and well motivated and who have the benefits of supervised rehabilitation. Surgical reconstruction yields satisfactory results even in the athletic injuries that receive attention late; the results are better than those following comparable industrial and occupational injuries to the proximal interphalangeal joints in older patients. The importance of this joint in future athletic competition and in later life makes the correct diagnosis and early treatment imperative.