Identifying and Treating a Dislocated Finger:
Dislocation of the finger is one of the most common injuries that occur in daily life. According to the American Academy of Orthopaedic Surgeons (AOS), there are over 300 different types of hand injuries. Most commonly, dislocations involve the fingers or thumbs. However, other parts such as hands, wrists, elbows and knees may also be involved.
The symptoms vary depending on which part of the body is affected. Some of these include:
Tenderness, swelling or redness around the area where the finger was dislocated. Pain may radiate from this point.
Pain that radiates up through your arm or into your shoulder, elbow or wrist.
Swelling of the affected joint(s) and/or pain with movement.
Redness, heat or tenderness of the skin surrounding the dislocated finger.
In some cases, there may be no symptoms at all. For example, if the finger is broken but not dislocated. If this happens, then you will probably have no problems even though you might feel a little sore when touching your damaged finger.
Dislocations are caused by extreme trauma. For example, falling directly onto an outstretched hand may cause a dislocated finger. Other causes may be due to direct blows to the affected part of the body. In some cases, external forces can lead to breaks or dislocations. For example, falling on an outstretched hand could result in a break but the force of the fall could also result in a dislocation of one or more fingers.
In most cases, the joint surfaces are damaged and no longer smooth. The surrounding ligaments may also be torn or stretched. In some severe injuries, bone fragments may be found outside of the joints. This is known as an open or compound fracture and requires medical attention as soon as possible for treatment.
IS IT A MEDICAL EMERGENCY?
Although dislocations are serious and should always be handled carefully by a professional, some are more serious than others. In most cases, dislocations are treated on a priority basis. Your physician will assess the injury and decide if the risk of permanent damage is high or not. In some cases, the risk is so low that treatment may be delayed until more serious conditions are treated first. The priority may also change as the patient’s medical history is taken.
For example, a dislocated finger may cause no problems at all if the dislocation is reduced (put back into place) immediately. In other cases, the dislocation is severe and pieces of bone may be found outside of the joints. In these cases, the dislocated pieces may damage blood vessels, nerves, tendons and other important structures and the damage may be severe enough to require surgery to repair or risk permanent damage.
Whether a dislocation is reduced (put back into place) immediately or not, it should be seen by a medical professional as soon as possible. Depending on the severity of the injury, treatment options may vary.
Most dislocations can be reduced (put back into place) by a trained medical professional.
Non-emergency: Most dislocations can be reduced (put back into place) by a trained medical professional. Depending on the degree of the dislocation, your physician may reduce (put back into place) the bone or bones in your finger(s). Some physicians may give you medication to help reduce the pain but in most cases, only local anesthetic is used. During this time, you may feel a snapping or popping sensation as your bones go back into place. You will then be instructed on how to care for the injury.
Emergency: It is important that you seek medical attention as soon as possible if your finger(s) has/have become swollen, blue or discolored at the joint(s). If you are having trouble feeling or moving your finger(s), you should seek medical attention immediately.
You may be given a sling to immobilize the joint if surgery is not necessary.
Surgery may be required if:
1. Severe nerve, tendon or muscle damage occurred during the dislocation.
2. You have given history of similar injuries in the past.
3. The joints seem unstable or do not go back into place.
4. Sensitivity is lost in the finger(s).
5. Your injury involves a broken bone in the finger.
A. Surgery is always an option and in some severe cases, it may be the only option to restore function and feeling to the finger. During surgery, your doctor may remove torn or damaged tissue and repair tendons, nerves or muscles as necessary. You may have a cast, splint or surgical wire to keep the finger in place as it heals. It is important that you keep your follow-up appointments to have the finger checked until released by your physician.
Sources & references used in this article:
Fracture–dislocation about the finger joints by RP Calfee, TG Sommerkamp – The Journal of hand surgery, 2009 – Elsevier
Identifying and treating traumatic hand and wrist injuries by M Kavin, FE Liss – Journal of the American Academy of PAs, 2018 – journals.lww.com
Traumatic and spontaneous dislocation of extensor tendon of the long finger by M Ishizuki – The Journal of hand surgery, 1990 – Elsevier