Finger Dislocation

Dislocation is an injury to a joint, where the linked bones shift from their normal position and no longer touch each other. Dislocation is common in the fingers. Subluxation is similar, except that the linked bones still touch. This is less common in fingers than dislocation. Bones often break along with dislocations or subluxations. Ligament sprains must occur for these injuries to happen.

SYMPTOMS

  • Severe pain, at the time of injury.

  • Pain with movement of the finger.

  • Loss of function of the joint.

  • Tenderness, obvious deformity, swelling, and bruising.

  • Numbness or paralysis below the injury, from pinching, cutting, or pressure on blood vessels or nerves (uncommon).

CAUSES

  • Direct or indirect hit (trauma).

  • Twisting injury.

  • Landing on the hand, finger, or thumb.

  • End result of a severe finger sprain or fracture.

  • Birth defect (congenital abnormality), such as shallow or malformed joint surface.

RISK INCREASES WITH:

  • Contact sports (baseball, football, basketball, soccer).

  • Previous finger and hand sprains or dislocations.

  • Repeated injury to any joint in the hand.

  • Poor hand strength and flexibility.

PREVENTION

  • Warm up and stretch properly activity.

  • Maintain proper conditioning, especially hand strength and flexibility.

  • To prevent recurrence, protect vulnerable joints after healing, with protective devices or tape.

PROGNOSIS

With proper treatment, healing may take up to 6 weeks.

RELATED COMPLICATIONS

  • Damage to nearby nerves or major blood vessels.

  • Finger fracture or injury to joint cartilage.

  • Excessive bleeding around the injury site.

  • Recurring dislocations.

  • Stiffness or loss of motion of the injured joint.

  • Unstable or arthritic joint, following repeated injury, surgery, or delayed treatment.

  • Longer healing time or recurring dislocation, if activity is resumed too soon.

TREATMENT

Treatment requires immediate repositioning of the joint (reduction) by a medically trained person. If that does not work, surgery may be needed. After repositioning, treatment involves ice and medicines to reduce pain and inflammation. The joint should be restrained by splinting, casting, or bracing for 2 to 6 weeks. This protects the joint while the ligaments heal. After restraint, stretching and strengthening exercises are advised for the injured and weakened joint and muscles. Exercises may be completed at home or with a therapist. Use of taping may be advised when returning to sports.

MEDICATION

  • General anesthesia or muscle relaxants may help make joint repositioning possible.

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised.

  • Do not take pain medicine for 7 days before surgery.

  • Stronger pain relievers may be prescribed by your caregiver. Use only as directed and only as much as you need.

HEAT AND COLD

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used before performing the stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm water soak.

SEEK MEDICAL CARE IF:

  • Pain, tenderness, or swelling gets worse, despite treatment.

  • You experience pain, numbness, or coldness in the finger.

  • Blue, gray, or dark color appears in the fingernails.

  • Any of the following occur after surgery:

  • Increased pain, swelling, redness, drainage of fluids, or bleeding in the affected area.

  • Signs of infection: headache, muscle aches, dizziness, or general ill feeling with fever.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)