Introduction: The management of acute proximal interphalangeal (PIP) joint fracture-dislocation by dynamic external fixator is widely practiced method. The complications such as pin loosening or non-union or stiffness are known and can be treated well. The over distraction causing vascular compromise and calcification of volar plate jeopardizing the function and viability of the affected digit is not reported so far. Case Report: We report a case of 2 weeks post-traumatic ring finger PIP joint fracture-dislocation in a 21-year-old male which was treated by pins and rubber dynamic traction method. The affected digit was found cold and lengthened at 3 weeks of distraction causing vascular compromise. The X-ray showed over distraction by 1.5 cm at PIP joint. The digit was salvaged by removing distractor and applying splintage. Later, at 6 weeks, X-ray showed volar plate calcification causing joint stiffness. This was tackled by volar plate arthroplasty. At 2 months, the patient got 20–80° movement without pain. Conclusion: The dynamic pins and rubber traction system for acute PIP joint injury can result in complication like over distraction leading vascular compromise. The clinical and radiological assessment with such technique is mandatory once a week to avoid missing such disasters. Even if such complication occurs, immediate fixator removal and splintage can save the digit. Once it survives, secondary procedure for gaining movement or stabilizing the joint like volar plate arthroplasty can be considered. Keywords: Pins and Rubbers traction system, Over distraction, Vascular compromise

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Background: A palmar dislocation of distal radio-ulnar joint (DRUJ) is rare and causes gross functional restriction of pronation. It is certainly major cosmetic concern for the patient as keeps the forearm supinated because of dislocation. Usually, such injuries are caused due to high velocity trauma and fall on supinated hand. The literature is sparse on the management of palmar dislocation of DRUJ. Materials and Methods: We present a case report on the management of chronic palmar dislocation in a 27-year-old professional gymnast trainer with 1-year follow-up. We describe the surgical technique of open reduction by palmar approach and reconstruction of triangular fibrocartilage complex ligament by suture anchor. The post-operative rehabilitation protocol is also mentioned in detail. Results: The patient has 80° pronation and painless wrist range of movements at 1-year follow-up. She is able to perform all activities of daily living though not confident in weight bearing on affected wrist. Conclusion: As per our knowledge, this is described for the 1st time about the management of chronic palmar DRUJ case in young gymnast. The restricted pronation is important sign of palmar DRUJ dislocation. The return of pronation gives immense satisfaction to the patient.