Finger Dislocations

Finger Dislocations

Ligaments are bands of fibrous tissue that connects bone and cartilage to support and strengthen joints. The bones in the joints of your fingers are connected by a joint capsule, which acts as a sleeve surrounding ligaments. In other words, every knuckle in your fingers contain a joint in between two bones. If you stretch a finger ligament beyond its strength, it tears or sprains. The classification of ligament sprains are: Grade I: 25% tearing of the ligament; Grade II: 25-75% tearing of the ligament; Grade III: complete tearing of the ligament.

Finger dislocation is a Grade III sprain. The most important thing is to make sure that the finger ligaments return to their normal length so it can heal and you can use your fingers properly.

Distal interphalangeal joints are the finger knuckles closest to the fingernails. Most of these dislocations are due to trauma and often there is an open wound at the location of the dislocation.

Proximal interphalangeal joints are the middle knuckles of the fingers. Most often these are known as “jammed finger” when athletes bend their fingers backward in contact with balls or other players.

Metacarpophalangeal joints are the joints within the hand where the hand connects to the fingers. Dislocations in these joints are less common because these joints are more stable. If dislocations do occur, most likely the index or little finger is affected.

Causes: jamming force applied to end of the finger, finger forcefully twisted or bent or overextended

Symptoms: A dislocated finger may appear crooked or awkwardly bent. The finger is usually painful and swollen. The surface skin may be cut or bruised. If the dislocated finger was straightened, the joint may feel weak or unstable or loose. There may be numbness and tingling of the dislocated finger. There will be a loss of function in the finger or restricted movement of the finger.

Diagnosis: X-ray to confirm dislocation and to check for fractures

Treatment: Do not attempt to straighten out your finger. Please seek medical care immediately. Delaying treatment increases permanent damage to the joint.

1. RICE: Rest the finger until Day 5 when you should start gentle motion exercises, apply Ice to finger (not directly onto skin) for 20 minutes up to 3 times a day for 2 days, Compression-see #3, Elevate the involved hand above the level of the heart as much as possible for the first few days or until there is decreased swelling (will help drain fluid and reduce swelling)

2. Reduction: realignment of the finger bones by the doctor. A local anesthetic may be injected for reduced pain during the reduction.

3. Splint/Tape: After the reduction, a splint may be applied or your finger may be taped to the finger next to it (buddy tape). In some situations, surgery or casting may be required.

4. Rehabilitation: Exercises to improve your range of motion and increase strength in your finger.

Prevention: To help prevent any finger dislocations, wear appropriate padding and safety equipment when playing sports or any physical activities. Do not break a fall with an outstretched arm. Put on a protective splint or buddy tape previously dislocated fingers.

Prognosis: Good long-term prognosis. It may take 4-6 months for the finger pain to disappear. There is a high chance for repeat dislocation of the same joint.