Metacarpophalangeal Joint Dislocation

You have a finger dislocation of the metacarpophalangeal (MCP) joint . This is the joint between the large bones in your hand and the bones of the finger that are closest to the hand (the knuckles). The most common fingers to dislocate in this area are the index finger and the thumb. Usually it occurs because of a hyper-extension injury. This means the finger or thumb has been forced to bend opposite of the way the fingers normally bend. A dislocation is a condition in which joint surfaces are forced into an abnormal relationship. These joint surfaces are normally next to each other. With this injury, the joint surfaces no longer butt against (oppose) each other. When this happens, X-rays are often taken. The x-rays are used to make sure a break in bone (fracture) is not present. These fractures are often difficult to bring back to normal position (reduce). If there is a fracture, you may require surgery.

TREATMENT

If the joint is dislocated you will require a reduction (re-alignment) of the joint. This is done with a local anesthetic or regional anesthetic (make the arm numb). Once reduced the injury is usually treated by splinting the joint in a flexed position. This keeps the joint stable and unable to have the final degrees of extension. You may have the split for several weeks. If there are related (associated ) fractures, you may require surgery with repair and internal fixation. Your caregiver can discuss these options with you.

HOME CARE INSTRUCTIONS

  • While awake, apply ice to the sore area for 15 to 20 minutes, 3 to 4 times per day for the first 2 days. Put the ice in a plastic bag. Place a towel between the bag of ice and your skin.

  • Keep your arm raised (elevated) above your heart when possible. This will lessen swelling.

  • Continue activities with your hand as directed

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

SEEK MEDICAL CARE IF:

  • You have an increase in bruising, swelling or pain in your finger

  • You notice coldness or numbness of your finger.

  • You do not get enough pain relief with medications.

SEEK IMMEDIATE MEDICAL CARE IF:

Your finger is progressively numb or blue, or you have severe pain.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.