FINGER DISLOCATION |
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General Information
DEFINITION--Injury to any finger joint so that adjoining bones are displaced from their normal position and no longer touch each other. Fractures and ligament sprains frequently accompany this dislocation. Finger dislocations are a common problem for athletes.
BODY PARTS INVOLVED
Any of the many finger bones.
Ligaments that hold finger bones in place.
Soft tissue surrounding the dislocation site, including periosteum (covering to bone), nerves, tendons, blood vessels and connective tissue.
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SIGNS & SYMPTOMS
Excruciating pain in the finger at the time of injury.
Loss of function in the dislocated joint.
Severe pain when attempting to move the injured finger.
Visible deformity if the dislocated finger has locked in the dislocated position. Bones may spontaneously reposition themselves and leave no deformity, but damage is the same.
Tenderness over the dislocation.
Swelling and bruising at the injury site.
Numbness or paralysis beyond the dislocation from pinching, cutting or pressure on blood vessels or nerves.
CAUSES
Direct or indirect blow to the hand, finger or thumb.
End result of a severe finger sprain.
Congenital abnormality, such as a shallow or malformed joint surface.
RISK INCREASES WITH
Contact sports, especially basketball, baseball and soccer.
Previous finger or hand dislocation or sprain.
Repeated injury to any part of the hand.
Arthritis of any type (rheumatoid, gout).
Poor muscle conditioning in the hand.
HOW TO PREVENT
To prevent a recurrence, protect vulnerable joints after healing with protective devices or tape.
Develop a high level of muscle strength and conditioning, including the hand area.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's treatment. This will include manipulating the joint to reposition the bones.
Surgery (sometimes) to restore the joint to its normal position and repair torn ligaments and tendons. Acute or recurring dislocations may require surgical reconstruction or eventual replacement of the joint.
Self-care during rehabilitation.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of the hand and wrist.
POSSIBLE COMPLICATIONS
AT THE TIME OF INJURY:
Shock.
Pressure on or injury to nearby nerves, ligaments, tendons, muscles, blood vessels and connective tissue.
AFTER TREATMENT OR SURGERY:
Impaired blood supply to the dislocated area.
Death of bone cells due to interruption of the blood supply.
Infection introduced during surgical treatment.
Excessive bleeding around the dislocation site.
Continuing recurrent dislocations with progressively less severe injuries.
Prolonged healing if activity is resumed too soon.
Unstable or arthritic joint following repeated injury or surgery.
PROBABLE OUTCOMEAfter the dislocation has been corrected, the hand may require immobilization with a cast or splint for 2 to 3 weeks. Complete healing of injured ligaments requires a minimum of 6 weeks.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
Use instructions for R.I.C.E., the first letters of REST,
ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
The doctor will manipulate the dislocated finger to return bones to their normal position. Manipulation should be done within 6 hours of injury. If not, many tissues lose their elasticity and become difficult to return to a normal position.
CONTINUING CAREAfter removal of the splint or cast:
Use ice soaks 3 or 4 times a day. Fill a bucket with ice water, and soak the injured area for 20 minutes at a time.
Apply heat if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Tape the injured finger to adjacent fingers.
Massage gently and often to provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
General anesthesia or local anesthesia to make joint manipulation possible.
Acetaminophen or aspirin to relieve moderate pain.
Narcotic pain relievers for severe pain.
Antibiotics to fight infection, if surgery is necessary.
ACTIVITY
If surgery is not necessary, activity is not restricted except for limitations imposed by immobilization of the hand.
If surgery is necessary, resume normal activities and reconditioning gradually.
DIET
Drink only water before manipulation or surgery to correct the dislocation. Solid food in your stomach makes vomiting while under general anesthesia more hazardous.
During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs.
REHABILITATION
Begin daily rehabilitation exercises when supportive wrapping is no longer needed.
Use ice massage for 10 minutes before and after workouts. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
Rehabilitation exercises must be individualized. Follow your doctor's or surgeon's directions.
CALL YOUR DOCTOR IF
You have signs or symptoms of a dislocated finger.
Any of the following occur after treatment:
Numbness, paleness or coldness in the finger. This is an emergency!
Swelling above or below the splint or cast.
Blue or gray skin color, particularly under the fingernails.
Any of the following occur after surgery:
Increased pain, swelling or drainage in the surgical area.
Signs of infection: headache, muscle aches, dizziness, or a general ill feeling and fever.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
Finger dislocations that you can "pop" back into normal position occur repeatedly.
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