Dislocated finger
| Dislocated finger | |
|---|---|
 | |
| X ray of a dislocated PIP joint (dorsal) of the 5th finger | |
 | |
| Specialty | Plastic surgery |
| Symptoms | Crooked finger, pain, swelling[1] |
| Usual onset | Late teenage years[2] |
| Types | DIP, PIP, MCP[2] |
| Risk factors | Sports that involve balls, gymnastics[3] |
| Diagnostic method | X-rays[1] |
| Differential diagnosis | Finger fracture, mallet finger[2] |
| Treatment | Joint reduction followed by splinting or buddy tapping for few weeks[4][3] |
| Frequency | Common[2] |
A dislocated finger is when one of the three joints of the finger is out of place.[2] Symptoms generally include a visibly crooked finger, pain, and swelling.[1] Complications may include ligament or tendon injury, which may result in instability or a boutonnière deformity.[5]
Common causes include sports that involve balls and gymnastics.[3] The underlying mechanism generally involves the finger getting bent backwards.[5] They includes DIP dislocations, PIP dislocations (most common), and MCP dislocation.[2][5] The most commonly affected MCP joint is that of the thumb.[4] Diagnosis is by X-rays.[1] They can be classified as dorsal, volar, or lateral based on the position of the bone farthest from the body.[2]
Treatment is by joint reduction, which can often be achieved by pulling on the finger.[5] This may be carried out following a ring block of the affected finger; though not always required.[5][4] Following reduction X-rays are done to verify success and the finger splinted or buddy tapped for a week or two.[4][3] If splinted, it may be recommended to remove the splint to move the finger daily.[4] When a fracture or instability is also present, management is more complicated.[3] Dislocated fingers are common.[2] They occur most often in the late teenage years.[2]
Management
DIP
When the dislocation is backwards, the finger is pulled on with pressure applied to push the distal phalanx forwards.[3] When the dislocation is forwards, the finger is bent at the tip and pulled on.[3]
PIP
When the dislocation is backwards, the PIP joint is straightened and the finger is pulled on.[3] When the dislocation is forwards, the PIP joint is bent and the finger is pulled on.[3] In backwards dislocations splinted or buddy tapped for a week or two is generally all that is required.[4][3] A small volar plate fracture (less than 30%) does not generally require a change in treatment, though larger fractures, decreased range of motion, or instability requires hand surgery follow-up.[4] In forwards dislocations splinting for 6 weeks with the finger straight maybe recommended.[4]
References
- ↑ 1.0 1.1 1.2 1.3 "Finger Dislocations - Injuries and Poisoning". Merck Manuals Consumer Version. Archived from the original on 13 February 2024. Retrieved 20 February 2024.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Taqi, M; Collins, A (January 2024). "Finger Dislocation". StatPearls. PMID 31855352.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 Miller, EA; Friedrich, JB (April 2020). "Management of Finger Joint Dislocation and Fracture-Dislocations in Athletes". Clinics in sports medicine. 39 (2): 423–442. doi:10.1016/j.csm.2019.10.006. PMID 32115092.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Borchers, JR; Best, TM (15 April 2012). "Common finger fractures and dislocations". American family physician. 85 (8): 805–10. PMID 22534390.
- ↑ 5.0 5.1 5.2 5.3 5.4 "Finger Dislocations - Injuries; Poisoning". Merck Manuals Professional Edition. Archived from the original on 23 March 2023. Retrieved 21 February 2024.