Simultaneous dislocations of the interphalangeal and metacarpo-phalangeal joints are rare. Most of the previous reports in the literature concerned closed injuries which were not associated with neurovascular involvement and were easily reduced and had favourable outcomes. They were also mainly due to a dorsally directed force on a hyperextended digit. We report a case of this rare injury due to a torsion force in a power drill accident resulting in an open injury with neurovascular damage and gangrene of the thumb distal to the wound despite re-vascularisation attempts.