How is a Dislocated Finger Diagnosed & What is its Treatment, Recovery and Prognosis

Each of our fingers is made up of three joints, while the thumb has two joints. These joints are what make it possible for us to bend and straighten our fingers. When any two bones get forced out of place at the joint, the finger becomes dislocated. This can happen due to a fall, sports injuries, and accidents. Dislocating a finger or a thumb can be a very painful and distressing experience. Even though a dislocation is not a life-threatening emergency, it is still necessary that you seek immediate medical attention. Here’s everything you need to know about how to identify and treat a dislocated finger.

Overview of a Dislocated Finger

Your finger has three joints, while the thumb is made up of two joints. These joints are what allows our fingers to straighten and bend.(1,2,3) However, when any of the two bones get forced out of place at the joint, the finger gets dislocated. A dislocated finger happens when the finger bone slips out of its joint, which can be extremely distressing and painful. A finger dislocation can happen because of traumatic falls, accidents, and sports injuries.(4,5) Even though a dislocation is not a life-threatening condition, you should still seek medical assistance at the earliest.

When a finger gets dislocated, the bones become out of alignment with the joint and are no longer together. The most common joint in the finger that experiences dislocation is the proximal interphalangeal (PIP) joint, which is the middle joint of the finger.(6,7)

What are the Symptoms of a Dislocated Finger?

A dislocated finger is likely to appear as crooked or swollen and is going to be very painful. Here are some other signs that your finger might be dislocated:

  • Your finger joint looks misshapen.
  • The finger bone appears to be dislodged, it might even be sticking out to one side.
  • There is bruising and swelling around the joint.
  • There is pain around the joint.
  • You are unable to move your finger.
  • There is a tingling sensation or numbness.
  • There is discoloration of the skin.
  • You have difficulty moving the injured finger.

What Are The Causes Of A Dislocated Finger?

As explained above, your fingers are made up of three joints, and the thumb is made up of two joints. A joint is a place where the ends of any two bones meet.

Meanwhile, to help support the joints, ligaments are present. Ligaments are the short bands of fibrous material that hold the bones together to help support the joints. A dislocation happens when there is a substantial amount of force that causes the ligaments to break or give way, thus causing the bone to slip out of place from the joint.(8,9,10)

Most of the time, dislocated fingers are caused by sports injuries, particularly sports played with a ball, like volleyball, basketball, and even football. Accidents and falls are the other common causes of finger dislocation. In a 2015 review of several studies, it was found that nearly half of all sports-related hand injuries tend to affect the fingers.

Football, basketball, lacrosse, wrestling, and gymnastics have been found to have the highest rates of hand injuries that affect the fingers.(11)

A 2017 study that looked at upper extremity injuries in National Football league (NFL) players found that 17 percent of all such injuries were proximal interphalangeal dislocations.(12) This is so because when a person is trying to block or catch a ball, it is easy for a finger to get jammed when the ball hits an outstretched finger. Since the ball strikes with immense force, it pushes the finger backward, pushing the bones away from the joint, thus leading to a dislocation.

Some other possible causes of a dislocated finger include:

  • Falling on an outstretched hand
  • Blunt force impact to the tip of the finger
  • Jamming of the finger or hand
  • Overextending the finger

In some cases, genetics may also have a role to play because some people are just born with weaker ligaments. Other times, people with certain health conditions that cause the joints and ligaments to become weak are also at a higher risk of having dislocations.(13)

How is a Dislocated Finger Diagnosed?

A doctor will first examine your finger and enquire about when and how the injury occurred. They will order an imaging test to confirm the dislocation and also determine the extent of damage caused to the finger. They may order either an X-ray or an MRI scan. X-ray images are commonly used to confirm the dislocation and also to check if there are any fractures or breaks. Meanwhile, if your doctor suspects significant tissue damage near the dislocated finger joint, they will order an MRI scan.(14,9)

Treatment for Finger Dislocations

There are several treatment options available for finger dislocations, and your doctor will choose a treatment plan depending on the severity and location of the dislocation.
Here are the typical steps involved in the treatment of a dislocated finger:

Reduction

Reduction is the first step in the treatment of a dislocated finger or thumb. It involves the careful manipulation of the finger bone back into the joint. Since this is going to be a painful procedure, your doctor is likely to use a local anesthetic to numb the affected part of the hand.

After completing the reduction procedure, your doctor may again order an X-ray to check that the alignment of the bone inside the joint has been done correctly.(15)

Immobilization

After the process of reduction, you will need to wear a splint to help protect and immobilize the dislocated finger for some time as it heals. A splint is made up of a rigid strip of metal that supports a dislocated or broken bone. Immobilization is necessary to stop you from moving the finger and also prevents further dislocation and injury to the affected finger.

Your doctor may also recommend buddy taping of the splinted finger to finger next to it. Buddy taping the affected finger to its adjacent finger helps provide support to the injured finger and also allows you to have a greater range of motion.

If you have a dislocated finger, you may need to wear the splint for a couple of weeks. However, your doctor will keep on checking your finger from time to time because wearing a splint for too long can also cause permanent stiffness and lead to a decreased mobility of the finger.(16)

K-wire Fixation

In some cases, the dislocation of the finger might be severe enough and accompanied by a bone fracture. A fracture happens when there is a lot of force being applied against a bone, causing it to break or splinter into two or more separate pieces.

Finger fractures often also require reducing and splinting, but some people with finger fractures may also need to undergo K-wire fixation. K-wires are thin metal rods that surgeons insert to help stabilize the bone fragments.(17)

Surgery

In some rare cases, dislocated fingers may also involve fractures, torn ligaments, or broken bones that may need you to undergo a surgical procedure known as open reduction. Similar to the other treatment options for a dislocated finger, surgery also aims to reduce, stabilize, and restore mobility to the finger while preventing damage to the surrounding structures of the finger and hand.(18)

It is important for you to understand that right after a dislocation, you should never try to pop back your finger into the joint by yourself. This can cause injury to the underlying structures, which can sometimes even be permanent. Damage can be caused to the underlying tendons, nerves, ligaments, and blood vessels.

While you wait to get to your doctor, ice the injured finger and try to keep it as immobile as possible. To ice, the finger, wrap some ice in a towel or use an ice pack. Avoid applying ice to the skin directly. Try not to drink or eat anything in case you need to undergo a surgical procedure.

Recovering From a Dislocated Finger

Dislocated fingers tend to heal within four to six weeks. However, there are certain factors that can affect the recovery time, including:

  • The extent of severity and location of the dislocation.
  • The extent of damage caused to the tendons and ligaments.
  • If there are any bone fractures or broken bones.
  • If you need surgery.

Physical or occupational therapy might be prescribed after the finger has recovered sufficiently to remove the splint. A trained physical therapist will help you learn exercises that will help you strengthen the finger and get back mobility in the joint. Your therapist may also administer heat and massage therapies that help in reducing the stiffness and also increase mobility in the finger joint.

You will be able to return to your regular activities, including playing sports, within a couple of weeks after your injury. However, it may take up to six months or longer for the finger to fully heal. In some cases where the finger dislocation is also accompanied by a serious bone break, or you did not receive prompt medical treatment, the pain and stiffness can even be long-lasting, sometimes even permanent.

Here are some things that can be done at home to speed up recovery of the dislocated finger:

  • Keep the splint dry and clean.
  • Try to keep the finger elevated above the level of your heart to decrease the swelling.
  • Rest the finger and avoid moving it as it heals.
  • Apply ice packs or cold compress to reduce pain and inflammation.

Regularly keep performing any finger exercises that your physical therapist has recommended to bring back strength to the finger and increase mobility once the splint is removed.

Continue taking any medications your doctor has prescribed or over-the-counter medications like acetaminophen or ibuprofen to reduce the pain and swelling.

After recovery, it is essential to keep in mind that a dislocated finger is going to be more susceptible to injury in the future. You can reduce the risk of dislocating your finger again by following certain tips:

  • Wear buddy tape or a splint while doing any sports.
  • Wear proper sporting equipment, especially any safety gear.
  • Perform hand and finger exercises to increase the strength in the affected muscles, ligaments, and tendons.
  • Avoid wearing rings while playing sports.
  • Do not walk if you feel unstable, and remove any type of tripping dangers from your floors to minimize the risk of falling.

Prognosis of a Dislocated Finger

Most people end up recovering from a dislocated finger with no permanent effects or pain. However, it is likely that your finger might be more prone to a dislocation again in the future, so remember to be careful and practice prevention. You should never attempt to relocate the dislocated finger by yourself. Remember that manipulating the injured finger can lead to additional injury and damage to the joint and the underlying structures. After the proper treatment, dislocated fingers should take a couple of weeks to heal. However, if there are bone fractures and damage to the surrounding structures, it can increase your recovery time.

References:

  1. Calfee, R.P. and Sommerkamp, T.G., 2009. Fracture–dislocation about the finger joints. The Journal of hand surgery, 34(6), pp.1140-1147.
  2. Kaplan, E.B., 1957. Dorsal dislocation of the metacarpophalangeal joint of the index finger. J Bone Joint Surg Am, 39(5), pp.1081-1086.
  3. KETTELKAMP, D.B., FLATT, A.E. and MOULDS, R., 1971. Traumatic dislocation of the long-finger extensor tendon: a clinical, anatomical, and biomechanical study. JBJS, 53(2), pp.229-240.
  4. Pursley, R. and Collins, A., 2019. Finger Dislocation.
  5. Ishizuki, M., 1990. Traumatic and spontaneous dislocation of extensor tendon of the long finger. The Journal of hand surgery, 15(6), pp.967-972.
  6. Borchers, J.R. and Best, T.M., 2012. Common finger fractures and dislocations. American family physician, 85(8), pp.805-810.
  7. Wilson, J.N. and Rowland, S.A., 1966. Fracture-dislocation of the proximal interphalangeal joint of the finger. Plastic and Reconstructive Surgery, 38(3), p.276.
  8. Bernard Kingston, 2000. Understanding joints: a practical guide to their structure and function. Nelson Thornes.
  9. Clavero, J.A., Alomar, X., Monill, J.M., Esplugas, M., Golanó, P., Mendoza, M. and Salvador, A., 2002. MR imaging of ligament and tendon injuries of the fingers. Radiographics, 22(2), pp.237-256.
  10. Leggit, J. and Meko, C.J., 2006. Acute finger injuries: part I. Tendons and ligaments. American family physician, 73(5), pp.810-816.
  11. Sciencedirect.com. 2021. [online] Available at: <https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0278591914000829/first-page-pdf> [Accessed 27 February 2021].
  12. Chen, F. and Kalainov, D.M., 2017. Phalanx fractures and dislocations in athletes. Current reviews in musculoskeletal medicine, 10(1), pp.10-16.
  13. Magnani, C., Tedesco, S.A., Dallaglio, S., Sommi, M., Bacchini, E., Vetro, A., Zuffardi, O. and Bevilacqua, G., 2009. Multiple joint dislocations: An additional skeletal finding in Lowry–Wood syndrome?. American Journal of Medical Genetics Part A, 149(4), pp.737-741.
  14. Lang, A.R., 1958. Direct observation of individual dislocations by X‐ray diffraction. Journal of Applied Physics, 29(3), pp.597-598.
  15. Barry, K., McGee, H. and Curtin, J., 1988. Complex dislocation of the metacarpo-phalangeal joint of the index finger: a comparison of the surgical approaches. The Journal of Hand Surgery: British & European Volume, 13(4), pp.466-468.
  16. Chan, D.Y., 2002. Management of simple finger injuries: the splinting regime. Hand Surgery, 7(02), pp.223-230.
  17. Gregory, S., Lalonde, D.H. and LT, F.L., 2013. Minimally invasive finger fracture management: wide-awake closed reduction, K-wire fixation, and early protected movement. Hand clinics, 30(1), pp.7-15.
  18. Barry, K., McGee, H. and Curtin, J., 1988. Complex dislocation of the metacarpo-phalangeal joint of the index finger: a comparison of the surgical approaches. The Journal of Hand Surgery: British & European Volume, 13(4), pp.466-468.

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