Finger Dislocation

By Kim Segler, OTR/L, CHT

Author: Kim Segler, OTR/L, CHT

Overview

A dislocated finger occurs when a finger bone slips out of its joint or normal position. Finger dislocation is a common injury. Fingers contain three joints and thumbs contain two and allow fingers to bend and straighten.  A joint is where the ends of two bones meet. Ligaments are short bands of fibrous tissue that hold the bones together and help support the joint. Dislocations can occur when a significant force causes the ligaments to give way, causing the bone to slip out of the joint. It can occur in any of the joints of any finger but occurs most often at the middle joint of the finger called the proximal interphalangeal joint (PIP) joint

Thumb in brace

Image of Injured Thumb

Causes

Typically a dislocated finger is caused by a jamming force to the end of the finger, forceful overextension of a finger or falling on an outstretched arm. Sports injuries are a common cause of dislocated fingers. People with health conditions that can weaken joints and ligaments may be at greater risk of dislocations.

 

Symptoms

A dislocated finger may appear swollen or crooked and is usually very painful. It may be bent upward or at strange angels. Other indications of a dislocated finger can be numbness/tingling, bruising or discoloration /pale appearance of the skin and difficulty moving the finger. Sometimes it may cause a break in the skin.

If you suspect a dislocation you should seek medical attention at once. When you dislocate a finger, your finger may also be sprained or broken. Sprains and breaks share similar symptoms to dislocation, so it can be difficult to determine which injury you have without seeking help. Do not attempt to move the finger back into joint yourself. Trying to relocate the finger without proper training can make the injury worse. You could injure other structures, sometimes permanently like blood vessels, tendons, nerves, ligaments or joint articular cartilage. Delaying a visit to a doctor for a finger dislocation can make final treatment much more difficult and can lead to delayed healing or permanent disability.

If there is loss of sensation, open areas of skin or the finger is cold, pale or bluish you should seek medical attention immediately.

It is not recommended that you treat a dislocation on your own as the balance of the biomechanics of the finger are complicated and this could lead to loss of full motion or altered posture of the finger. If you have a dislocated finger the finger will swell. Immediately remove any jewelry, such as rings. Apply an ice pack to your hand and elevate the hand above the level of your heart. Use an ice pack or wrap ice in a towel. Do not apply ice directly to the skin.

 

Treatment

The doctor will examine the finger you have injured. He or she will X-ray the finger to confirm the dislocation and look for any broken bones as well as evaluate for tendon and ligamentous injuries that might accompany the dislocation. Treatment options vary depending on the location and severity of the dislocation.

  • Reduction is a medical term for repositioning the bone back into its proper place. The doctor may use a local anesthetic to numb the area and lessen your pain during the procedure. The doctor will then move the finger to realign the finger.
  • Splinting or immobilization will follow to protect the injured finger while it heals. Immobilization stops a person from moving their finger and prevents dislocating the finger again. In addition to a splint, or sometimes instead of a splint, your doctor may use tape to buddy tape the finger to an uninjured finger to allow early motion to prevent joint stiffness and loss of motion.

Dislocated fingers that involve torn ligaments, fractures, or broken bones may require surgery. Surgery is usually only used when reduction fails to stabilize the joint, or if you have complicated fractures or breaks.  Surgery may involve K-wires or open reduction. K-wires are thin metal rods that surgeons implant to help stabilize bone fragments. Open reduction involves an incision and typically screw fixation to properly align and stabilize the bone fragments. Surgical procedures aim to reduce, stabilize and restore mobility to the finger without damaging surrounding structures.

 

Physical Therapy and Recovery

Referral for occupational or physical therapy may be needed. Typically therapy involves working with a Certified Hand Therapist which could be an occupational therapist or a physical therapist. The therapist helps to guide the patient through the rehabilitation process providing education, splinting, range of motion exercises, control of swelling and pain symptoms and strengthening as prescribed by your doctor.

Healing may take a few weeks to six months depending on the severity of the injury and treatment.  In some cases with a dislocation accompanied by a severe break or medical treatment is not prompt, pain and stiffness can be long lasting or permanent. Some permanent swelling may be expected.


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