What to do About a Finger Dislocation
A finger dislocation is a joint injury in which the finger bones move apart or sideways. The ends of the bones are no longer aligned normally. Finger dislocations usually happen when the finger is bent backward beyond its normal limit of motion. The bones that make up the joints of the fingers are known as phalanges and metacarpal bones.
A dislocated finger is crooked, painful and swollen, and its surface skin may be cut, scraped or bruised. If a dislocated finger has been straightened on the playing field, it may feel abnormally loose, weak or unstable afterward. There are three finger joints that are susceptible to dislocation.
Distal interphalangeal joints are the finger joints closest to the fingernails. Most dislocations in these joints are caused by trauma, and there is at times an open wound in the location of the dislocation.
Proximal interphalangeal joints are the middle joints of the fingers. A dislocation in one of these joints is also known as a jammed finger or coach's finger. It is the most frequent hand injury in athletes, especially among those who play ball-handling sports (football, basketball and water polo). In most cases, the dislocation happens because the fingers are bent backward when an athlete tries to catch a ball or block a shot. Proximal interphalangeal joint dislocations also can happen when an athlete's fingers are twisted or bent by an opponent, especially when two athletes wrestle or grab for control of a ball.
Metacarpophalangeal joints are in the knuckles, located where the fingers meet the rest of the hand. These joints connect the metacarpal bones in the palm with the first row of phalanges in the finger. Because these joints are very stable, metacarpophalangeal joint dislocations are less common than the other two types. When metacarpophalangeal dislocations do occur, they are usually dislocations of either the index finger or little finger (pinky).
A dislocated finger can be corrected with or without injecting local anesthesia. To correct the dislocation, the doctor will press against the displaced bone to dislodge the bone if it is caught against the side of the joint. As the end of the bone is freed, the doctor can pull outward to restore the bone to its correct position. This is called closed reduction. Once your finger joint is back in its normal position, you will wear a splint or tape the finger to another finger for three to six weeks, depending on the specific type of your dislocation.
If the doctor cannot straighten a finger using closed reduction, or if your injured joint is not stable after closed reduction, your dislocated finger may need to be repaired surgically. In most cases, your doctor will order an X-ray of the finger to look for a fracture. When a finger bone is pulled away from connected tendons, it is common for a fragment of bone to separate from the main bone and stay with the tendon, a condition known as an avulsion fracture. Surgery is also used to treat finger dislocations that are complicated by large fractures or fractures that involves the joint. If you need surgery to repair your dislocated finger, it usually takes weeks to months before you can return to your sport.
After your dislocated finger has been treated, you often can prevent it from being injured again by using a protective splint, taping it to another finger or, in some cases, using a cast. The long-term outlook is usually good, although it may take four to six months for your finger pain to disappear. In some cases, there is also a small amount of permanent swelling around the injured joint, especially an injured proximal interphalangeal joint. In athletes, a finger that has been dislocated often is injured again.
Call your doctor immediately if you injure your finger and your finger is crooked, deformed, painful or swollen. If you are an athlete and someone straightens your injured finger on the playing field, check with your doctor to make sure that the injured joint is stable and not fractured. A dislocated joint that has an open wound should not be moved. It should be carefully splinted and evaluated immediately by a physician.
For more information or to request an appointment, please contact Dr. Patrick McDaid, M.D. at www.mcdaidorthohand.com/contact
Source: Harvard Medical School
