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Illustration demonstrating the forces acting on a dorsal fracture-dislocation of the proximal interphalangeal joint. The tension balance may be altered in the injured joint, resulting in increased instability. The pull of the flexor digitorum superficialis (FDS) tendon flexes the middle phalanx (P2), tilting its base dorsally. This allows the central slip (Ext) to pull the middle phalanx base into a dorsally subluxated position. P1 = proximal phalanx, VP = volar plate
