The most effective means of reducing a fixed flexion deformity is through the use of serial casting. The cast is fabricated, bearing in mind the necessity for a 3 point pressure to be applied, using biomechanical principles, whereby the MCPJ is stabilized by a volar slab that extends into the palm and through the use of levers. The proximal phalanx and metacarpal of the corresponding finger form 1 lever and the middle and distal phalanx forms a second lever. The dorsum of the

PIPJ dislocations frequently present at a late stage - usually 3 months following the injury. The GP generally diagnoses a finger sprain and suggests that the patient buddy straps the finger to the adjacent finger. They generally do not mobilize the finger for a few weeks and at 1 month they have developed a pseudo Boutonniere deformity, often with reciprocal hyperextension of the DIP joint. These fixed flexion deformities usually have an associated collateral ligament injury