A 20-month-old infant sustained an irreducible epiphyseal fracture-dislocation of a proximal interphalangeal joint. The dorsal dislocation of the joint was associated with a 90 degree rotational displacement (Salter-Harris Type I fracture) of the epiphysis of the middle phalanx. This injury, which seems not to have been described previously, required open reduction through both volar and dorsal incisions because the intact collateral ligaments and extensor central slip did not permit adequate distraction of the joint.

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