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Dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint, often accompanied by palmar lip fractures, are commonly seen in hand trauma. Management of these fractures requires restoring joint congruity and stability while allowing for early mobilisation. This case report discusses the successful use of a hemi-hamate autograft for reconstruction of the base of the middle phalanx in a young male patient with a severe dorsal PIP joint fracture-dislocation. The results demonstrate a promising technique for joint restoration with minimal functional impairment and excellent postoperative outcomes.