Finger

Dislocated index finger knuckle: The request could not be satisfied

Содержание

Finger Dislocation – StatPearls – NCBI Bookshelf

Continuing Education Activity

Finger joint dislocation is a common hand injury. Finger dislocation can occur at the proximal interphalangeal (PIP), distal interphalangeal (DIP), or metacarpophalangeal (MCP) joints. Unrecognized or untreated finger dislocations are associated with deformities, stiffness, loss of function, and chronic pain. This activity reviews the epidemiology, anatomy, key examination findings, imaging, treatment, and complications of finger dislocation. The activity also highlights the role of the examiner in evaluating potential complications and the importance of orthopedic and hand surgery consultations to improve care for patients with finger dislocations.

Objectives:

  • Review the anatomy of the important stabilizers of the finger joints.

  • Describe a proper patient history and physical exam and choose the correct imaging during an evaluation of finger joint dislocations.

  • Outline the nonoperative treatment options for MCP, PIP, and DIP joint dislocations and potential complications of the missed treatment.

  • Summarize the importance of communication between players, healthcare professionals and orthopedic or hand surgeons.

Access free multiple choice questions on this topic.

Introduction

Finger joint dislocation is a common hand injury. Finger dislocation can occur at the proximal interphalangeal (PIP), distal interphalangeal (DIP), or metacarpophalangeal (MCP) joints. This paper discusses the epidemiology, anatomy, examination, imaging, treatment, and complications of finger dislocation.

Fingers have three joints: the metacarpophalangeal (MCP) joint, the proximal interphalangeal (PIP) joint, and the distal interphalangeal (DIP) joint. The MCP joint is between the metacarpals and proximal phalanges. The PIP joint is a hinge joint between proximal and middle phalanges. The DIP is also a hinge joint and is between the middle and distal phalanges. The range of motion of these joints allows for flexion and extension, which provides grasping, pinching, and clawing or reaching functions of the fingers. The middle phalanx range of motion at the PIP joint is 105 +/- 5-degrees and accounts for the majority of the flexion of the fingertip during grasping. Flexion and extension of the digit are also possible at the metacarpophalangeal joint; however, the MCP joint can also perform adduction, abduction, and circumduction.[1]

The phalangeal joints have important stabilizers that provide necessary support during motion. Joint stabilizers are both static and dynamic. Static stabilizers consist of non-contractile tissue, including the collateral ligaments, volar plate, dorsal capsule, sagittal bands, and ulnar and radial collateral ligaments. The volar plate is an essential stabilizer as it reinforces the volar side of the joint capsule and maintains stability by preventing hyperextension of the finger joints.[2] The collateral ligaments provide the stabilization against radial and ulnar deviation of the interphalangeal joints. Sagittal bands encircle the MCP joint to keep the extensor tendon centralized and to prevent bowstringing. Dynamic stabilizers include extrinsic and intrinsic tendons and muscles, and two important dynamic stabilizers are the central slip and lateral bands. The central slip tendon is found dorsally and provides for PIP joint extension, and the lateral bands provide DIP joint extension. Finally, digital arteries and nerves are found volarly and appear on both ulnar and radial sides of the digit.[2][1]

Etiology

Finger dislocations can involve the MCP, PIP or DIP joints and may occur in the dorsal, volar, or lateral planes. Dislocations categorize, according to the position of the distal bone relative to the more proximal bone.[3]

Hyperextension or high-energy axial loads at the MCP joint can result in dislocation. MCP joint dislocation infrequently occurs because of the protection against hyperextension by the volar plate and radial and ulnar deviation by the collateral ligaments. The most common MCP joint dislocation is the index finger. MCP joint dislocation of the middle finger occurs more frequently when it is subjected to ulnar stress while in hyperextension.[2] Most common MCP joints dislocate dorsally.[3] The typical presentation of MCP joint dislocation is with the IP joint in flexion and the MCP joint in extension. A nonreducible dislocation with dimpling on the volar surface indicates volar plate interposition.[1]

PIP joint dislocations are the most common dislocation due to sports and are also known as “coach’s finger.” The typical presentation of PIP joint dislocation is deformity, decreased range of motion, and pain. PIP joint dislocations can classify into dorsal, volar, and lateral dislocations.  PIP joint dislocation is most commonly dorsal; however, volar dislocation correlates with a higher rate of complications and more difficult reductions.[3][1] Dorsal dislocation results result from longitudinal compression and hyperextension commonly by a ball hitting the fingertip.

Dorsal PIP joint dislocation most commonly occurs at the middle finger and is associated with volar plate, collateral ligament, and dorsal joint capsule injury. Swan neck deformity most often occurs in dorsal dislocations and results from volar plate injury. Trapping of the volar plate inside the joint may occur, causing malalignment and oblique rotation resulting under challenging reductions. Volar dislocation of the PIP joint can occur with and without rotation of the intermediate phalanx. Volar dislocation is infrequent and can be associated with injury to the central slip of the extensor tendon. Untreated rupture of the central slip after PIP joint dislocation is associated with pseudo-boutonniere (PIP flexion contracture). Pseudo-boutonniere is a chronic PIP joint flexion with the absence of DIP extension. 

Lateral PIP dislocation can also occur and involves disruption of the collateral ligaments.  The patient presents with joint instability and the widening of the joint on radiographs. Finally, rotary volar dislocations may occur when the phalanx displaces and rotates around one collateral ligament, allowing the proximal phalanx to wedge itself between the lateral band and extensor tendon. The classic lateral radiographic finding has the description of “Chinese finger-trap.”[1] 

DIP joint dislocations typically present with deformity at the fingertip. Dorsal, lateral, and volar DIP joint dislocations are all possible.  Dorsal DIP joint dislocations occur most frequently and are associated with fractures and skin injuries. They are not always associated with flexor tendon avulsions but may have an interposed volar plate causing a non-reducible dislocation. Volar DIP joint dislocations are similar to dorsal PIP joint dislocations in that both are associated with extensor tendon injuries. The lateral DIP joint is more likely to have post-reduction instability than volar or dorsal dislocations. Isolated DIP joint dislocation without related injuries such as soft tissue or fractures is rare and is commonly managed with closed reduction and splinting in the emergency departments. [4][1]

Epidemiology

From 2004 to 2008, approximately 166000 finger dislocations received treatment in US Emergency Departments. Most dislocations occur between fifteen and nineteen years of age and affect African Americans more than other racial groups. They occur most commonly in basketball and football players.[5]

History and Physical

Examiners must perform a complete history, which includes risk factors such as Ehlers-Danlos syndrome, mechanism of injury, handedness, previous finger injuries, occupation, and hobbies. Ample lighting should be used to examine the hand for skin integrity, ecchymosis, swelling, or bony deformity. If skin integrity becomes compromised due to laceration or abrasion, the goal of the examiner is to evaluate in a bloodless field if possible. Examiners may use finger tourniquets or, in a patient with adequate circulation, an anesthetic with epinephrine can be used.[6] Finger examination must be through its complete active and passive range of motion. [7]

A thorough neurovascular exam is imperative in the evaluation of the injured hand. The injured digit should be compared to the same digit on the unaffected hand for light-touch, pinprick, and 2-point discrimination to identify any potential digital nerve injury. The digital artery can be evaluated by comparison to an unaffected digit on the opposite hand with the use of a capillary refill. If the examiner identifies a deformity, the examiner must also determine if there is any rotation or angulation. Hyperextension of the finger joint should be performed to asses the competency of the volar plate. Lateral stress of finger joint is performed to test the collateral ligaments. To evaluate the integrity of the central slip, the Elson test is preform.  To assess for rotation or angulation, the patient is asked to make a fist if possible, and all the fingertips should point toward the scaphoid. Overlapping or “scissoring” indicates a rotational component to the injury. Rotated or angulated fractures are also identifiable by comparison of the digital pulp and nails with the unaffected hand. Palpation can be used to determine the location of maximal tenderness.[3]

Evaluation

The standard of care for evaluating injuries to the hand is plain film imaging. For each affected digit, true lateral, anterior-posterior, and oblique views are necessary. The films must demonstrate a clear view of the affected digit.  Unaffected fingers must not obscure the view of the affected digit. Examiners should keep in mind that rotational deformities are most commonly diagnosed on the physical exam rather than on plain films.[3] In addition to plain films, ultrasound (US) continues to be an area of research regarding the identification of fractures and tendon ruptures.[8]

Treatment / Management

Treatment of MCP, PIP, and DIP joint dislocation may be operative or nonoperative depending on the ease of reduction, post-reduction stability, or involvement of the volar plate or other stabilizing structures.  Before any reduction, a digital nerve block using lidocaine, bupivacaine, or tetracaine injected at the dorsal base of the dislocated finger will provide immediate anesthesia. [9]

Non-operative management of MCP joint dislocations consists of closed reduction and splinting. The clinician can achieve closed reduction by extension and axial compression on the proximal phalanx with relocating pressure over the phalangeal base to glide it into position. This approach is different than the traction technique used in PIP joint dislocation. Multiple reduction attempts should be avoided as the inability to reduce may indicate volar plate interposition requiring open reduction.  Multiple attempts at MCP joint dislocation reduction have the potential complication of displacing the volar plate between articular surfaces, lumbricals, or flexor tendons. The finger should have splinting with the wrist extended 30 degrees and MCP joint in 30 to 60 degrees of slight flexion to prevent terminal extension for about 3 to 6 weeks, followed by an additional two weeks of buddy taping. 

Operative intervention is indicated for nonreducible MCP joint dislocation as there is a high likelihood of volar plate involvement in these cases. Open reduction of MCP joint dislocation can be performed using either a dorsal or volar approach; however, the dorsal approach is preferable as it carries a lower risk of neurovascular injury. After surgery, the wrist is splinted in 30-degrees of extension with the MCP joint in slight flexion for two weeks to prevent terminal extension. The recommendation is that the PIP and DIP joints not be immobilized. Recovery to preinjury motion typically occurs between 4 to 6 weeks.[10]

PIP joint dislocations are also manageable with operative and nonoperative options, but unlike MCP joint dislocations, practitioners must determine if the PIP joint dislocation is dorsal, volar, lateral, or rotary as the treatment may differ. For closed reduction of dorsal PIP joint dislocation, the practitioner should apply slight extension and longitudinal traction, and with the other hand, apply pressure to the dorsal aspect of the proximal phalanx to relocate the displaced digit. After reduction, the examiner should evaluate the joint for instability in all planes and obtain radiographs. The normal contour of the dorsal aspect of the PIP joint on lateral plain film is “C” shaped.  If, after reduction, this contour takes on a “V” shape, it may indicate persistent dorsal subluxation, which can lead to severe stiffness.[2] PIP joint dislocation is often stable after reduction and is treated by dorsal splinting in 30-degrees of flexion. Volar PIP dislocations are the least common, but the reduction of the volar PIP joint dislocation is generally successful. The reduction takes place by applying mild traction with the PIP and MCP joints held in slight flexion. After the reduction of the volar dislocation, apply extension splint for six weeks. Unlike volar PIP joint dislocation, lateral dislocations are more likely to require operative intervention. Closed reduction requires relaxation of the extensor tendon and lateral bands by wrist extension and MCP flexion, respectively. Then the middle phalanx is gently rotated back into position. If reduction of the lateral PIP joint dislocation provides a full range of motion without subluxation, then the joint is not grossly unstable. In these cases, splinting and reassessment in two or three weeks is recommended. All unstable dislocations require referral for orthopedic evaluation and possible open repair.  Indications for operative intervention regarding PIP joint dislocation include joint instability, significant ligament, soft tissue or tendon injury, or dislocations that are not reducible. 

Splinting remains the mainstay of emergency treatment post-reduction. A recent randomized control trial compared buddy taping versus aluminum orthosis treatment of Eaton grades I and II hyperextension type injuries and found no difference in strength, pain, or function at three weeks. However, buddy tape did show an earlier range of motion and decreased edema.[11]

DIP joint dislocation management is less complex then PIP joint dislocation. The three types of DIP joint dislocation are dorsal, volar, and lateral. The most common type of DIP joint dislocation is dorsal. Dorsal DIP joint dislocation is reduced with longitudinal traction, relocating dorsal pressure on the distal phalanx with DIP joint in flexion. Often, the reduction occurs easily in the emergency room setting, followed by splinting of DIP in 10 to 20-degree flexion for two to three weeks.[4]  If there is persistent DIP joint instability, such as those found more commonly in lateral dislocation, then it is treated with four to six weeks of K-wire fixation after concentric reduction. Irreversible dislocation is typically due to volar plate interposition and requires surgical intervention.

Complications

  • Chronic stiffness is common after DIP dislocation treatment.

  • Overtreatment, such as prolonged splinting and multiple attempts of reduction of volar PIP joint dislocations, increases the likelihood of volar plate scarring and flexion contractures. 

  • Chronic pain

  • Reduced mobility of MCP, PIP, and DIP joints.

  • Missing or delayed volar plate injuries are associated with boutonniere deformity, swan neck deformity, laxity, and contractures.

  • Swan neck deformity, PIP flexion contracture, mallet finger deformity may also occur if the dislocations of the finger are chronically unrecognized.

Deterrence and Patient Education

Physical therapy, occupational therapy, and return to play or work training are often necessary. The orthopedic or hand surgeon should give education on how to care for the injury until recovery is complete. 

Enhancing Healthcare Team Outcomes

Finger dislocation evaluation, management, and treatment are complex. Orthopedic and hand surgeon consultation and close follow up are critical to decreasing the likelihood of the many complications associated with this injury. Since finger dislocation most commonly occurs in athletes, the discussion for return to play is also complex and requires communication between the orthopedic specialist, hand surgeon, and player. An orthopedic nurse can assist in the care, answer patient questions, assist during any procedural interventions, serve as a bridge between therapists and the clinician, and monitor progress towards healing. Physical and/or occupational therapy may be in order, with the therapist providing and charting updates so the entire team is aware of the current patient status. Specialists and nurses collaborating as an interprofessional team can enhance outcomes in diagnosing and managing finger dislocations. [Level 5]

References

1.
Prucz RB, Friedrich JB. Finger joint injuries. Clin Sports Med. 2015 Jan;34(1):99-116. [PubMed: 25455398]
2.
Sundaram N, Bosley J, Stacy GS. Conventional radiographic evaluation of athletic injuries to the hand. Radiol Clin North Am. 2013 Mar;51(2):239-55. [PubMed: 23472589]
3.
Hile D, Hile L. The emergent evaluation and treatment of hand injuries. Emerg Med Clin North Am. 2015 May;33(2):397-408. [PubMed: 25892728]
4.
Wang QC, Johnson BA. Fingertip injuries. Am Fam Physician. 2001 May 15;63(10):1961-6. [PubMed: 11388710]
5.
Golan E, Kang KK, Culbertson M, Choueka J. The Epidemiology of Finger Dislocations Presenting for Emergency Care Within the United States. Hand (N Y). 2016 Jun;11(2):192-6. [PMC free article: PMC4920528] [PubMed: 27390562]
6.
Ilicki J. Safety of Epinephrine in Digital Nerve Blocks: A Literature Review. J Emerg Med. 2015 Nov;49(5):799-809. [PubMed: 26254284]
7.
Gaston RG, Chadderdon C. Phalangeal fractures: displaced/nondisplaced. Hand Clin. 2012 Aug;28(3):395-401, x. [PubMed: 22883890]
8.
Tayal VS, Antoniazzi J, Pariyadath M, Norton HJ. Prospective use of ultrasound imaging to detect bony hand injuries in adults. J Ultrasound Med. 2007 Sep;26(9):1143-8. [PubMed: 17715307]
9.
Yin ZG, Zhang JB, Kan SL, Wang P. A comparison of traditional digital blocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digital block trials. J Hand Surg Br. 2006 Oct;31(5):547-55. [PubMed: 16930788]
10.
Calfee RP, Sommerkamp TG. Fracture-dislocation about the finger joints. J Hand Surg Am. 2009 Jul-Aug;34(6):1140-7. [PubMed: 19643295]
11.
Paschos NK, Abuhemoud K, Gantsos A, Mitsionis GI, Georgoulis AD. Management of proximal interphalangeal joint hyperextension injuries: a randomized controlled trial. J Hand Surg Am. 2014 Mar;39(3):449-54. [PubMed: 24503231]

So You Jammed Your Finger: Now What?

How many times have you hurt your finger during a volleyball or basketball game, family wrestling match, or even tucking in your sheets while making the bed? Sometimes it goes away after a few days or a week. Other times you may need medical attention. If your finger can’t move like normal – if you can’t bend or straighten it with normal effort, or if you feel sharp shooting pain – you may have an injury that you can’t fix yourself.

The three cylindrical bones of the finger (the phalanges) are in line with each other and require ligaments to help them remain aligned while the tendons flex and extend the fingers. Ligaments attach bone to other bone. When a finger is jammed, the stress along the joints can cause any of these structures to fail: ligaments can tear, tendons can rupture and bones can fracture.

If the sides of your finger are red and swollen, it could be a ligament sprain of one of the collateral (side) ligaments. If it’s tender on the bottom, you may have bent your finger backwards (another ligament injury). A sprain can be mild (overstretched) to severe (a large portion is torn or completely detached). Sharp pain could signal a break.

In one common injury the tip of the finger can’t straighten out. It droops into a flexed position, and can’t straighten without help. This is called a “mallet finger” and always needs intervention from a skilled medical professional. Contact a hand surgeon (an orthopedic specialist in conditions of the upper extremity) for proper management.

It’s also good to make a mental note of the injury: date of injury, what you were doing, how it happened, what force and what angle was the force directed, and what position your finger was in during the accident. This information can help guide your treatment and recovery and avoid a similar injury in the future. Ice your finger immediately after the injury to decrease swelling and reduce pain.

If you’re having continued pain and difficulty with motion, a visit to a hand doctor is a good idea to prevent long-lasting deficits and get you back to full mobility.

First aid for finger fractures and dislocations

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Fractures and dislocated fingers are common injuries, especially in contact and ball sports. 

Injuries to the fingers can result in significant loss of hand function. Even the simple ‘trapped’ finger, if not diagnosed and treated promptly, can lead to decreased motion and a poor outcome. Finger fractures may appear relatively minor, however, given the intricate function of the fingers these injuries require careful evaluation, early diagnosis and appropriate treatment to ensure there is no permanent disability or deformity.

Fractures and dislocations of the phalanges (fingers) occur from a variety of mechanisms. In younger patients, these injuries are more likely to be sports-related, while older patients are likely to be injured by machinery or falls.

Finger dislocations are a common injury. Dislocations occur when the bones of the finger are moved from their normal position, causing damage to the ligaments surrounding the joint.

Finger dislocations can occur in any of the joints of any finger, but most often occurs in the middle knuckle of the little, ring, middle, or index finger. Dislocation of the finger joints (including the thumb) are commonly seen in ball sports, for example football, netball, basketball and cricket when the finger is hit on the end by the ball.

Symptoms include deformity, impaired function, pain and immediate swelling followed by bruising.

Fractures of the bones of the finger are less common than joint dislocations but often also occur as a result of being hit on the end of the finger in many ball sports. Pain, swelling and deformity may be felt and the break should be iced and immobilised.

Clinical presentation of finger fractures and dislocations depends primarily on the mechanism of injury. Crushing injuries to the fingertip commonly involve the nail bed in addition to the underlying distal bone.

Injuries at the joints usually present with swelling, bruising and reduced motion. Deformity may also be present at the joint as well as in the mid-section of the bone of a displaced, unstable fracture.

Finger fractures that are non-displaced or stable are usually simply treated by immobilisation, usually splinted to another finger, however, open or unstable may required addition hospital treatment, in some cases even surgery.

Thumb injuries may require a longer period of immobilization, especially if there is clinical concern that a ligament was torn.

As with all fractures, a careful history should include the mechanism and time of injury, associated injuries, and the extent of any deformity. The physical examination should also include an assessment of swelling, neuro-vascular status, range of motion, and presence of open injury.

Swelling can be controlled using ice and immobilisation is very important, ideally and one should always seek medical advice.

Stiffness and lack of movement are common long-term symptoms if the finger is not managed effectively. In general, management of soft tissues is the first priority (after addressing any airway, breathing and circulation issues and any other more serious injuries), especially is bleeding or open wounds are present. The appropriate use of splinting is a key component of treating finger fractures and dislocations. 

Finger, Hand, and Wrist Injuries

Do you have a finger, hand, or wrist injury?

Yes

Finger, hand, or wrist injury

No

Finger, hand, or wrist injury

How old are you?

Less than 5 years

Less than 5 years

5 years or older

5 years or older

Are you male or female?

Why do we ask this question?

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Has it been more than a month since the finger, hand, or wrist injury?

Yes

Finger, hand, or wrist injury over a month ago

No

Finger, hand, or wrist injury over a month ago

Have you had finger, hand, or wrist surgery in the past month?

If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.

Yes

Fingers, hand, or wrist surgery in the past month

No

Fingers, hand, or wrist surgery in the past month

Do you think that any of your fingers might have frostbite?

Yes

Cold temperature exposure

No

Cold temperature exposure

Have you had a major trauma in the past 2 to 3 hours?

Yes

Major trauma in past 2 to 3 hours

No

Major trauma in past 2 to 3 hours

Are you having trouble moving your fingers or hand normally?

Pain or swelling can limit movement.

Yes

Difficulty moving fingers or hand

No

Difficulty moving fingers or hand

Can you move the fingers, hand, and wrist at all?

Yes

Able to move the fingers, hand, and wrist

No

Unable to move the fingers, hand, and wrist

Have you had trouble moving the fingers, hand, or wrist for more than 2 days?

Yes

Difficulty moving hand for more than 2 days

No

Difficulty moving hand for more than 2 days

Is there any pain in the fingers, hand, or wrist?

Yes

Pain in fingers, hand, or wrist

No

Pain in fingers, hand, or wrist

Has the pain:

Gotten worse?

Pain is increasing

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is improving

Do you have any pain in your fingers, hand, or wrist?

Yes

Finger, hand, or wrist pain

No

Finger, hand, or wrist pain

How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

Has the pain:

Gotten worse?

Pain is getting worse

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is getting better

Has the pain lasted for more than 2 days?

Yes

Pain for more than 2 days

No

Pain for more than 2 days

Is your hand blue, very pale, or cold and different from the other hand?

If the hand or arm is in a cast, splint, or brace, follow the instructions you got about how to loosen it.

Yes

Hand is blue, very pale, or cold and different from other hand

No

Hand is blue, very pale, or cold and different from other hand

Is any part of a finger partially or completely cut off?

Yes

Part of finger cut off

No

Part of finger cut off

Is it more than the tip of the finger or more than half the size of a dime, or can you see the bone?

Gently wash off any dirt, wrap the cut-off part in a clean cloth, put the wrapped part in a plastic bag, place the bag on ice to keep the digit cool and bring it to the hospital.

Yes

More than tip of finger severed

No

More than tip of finger severed

Was the finger or wrist twisted or bent out of its normal position, even if it is back in its normal position now?

Yes

Finger or wrist is or was dislocated

No

Finger or wrist is or was dislocated

Is the finger or hand trapped in something, like a jar or a toy?

Yes

Trapped finger or hand

No

Trapped finger or hand

Is there an object stuck in your finger or hand, and you can’t get it out?

This could be something like a nail, a needle, or a large piece of wood, metal, or plastic.

Yes

Embedded object in finger or hand

No

Embedded object in finger or hand

Has your hand or finger been injected with something under high pressure, like oil or paint from a sprayer?

Yes

Hand or finger injected with something under high pressure

No

Hand or finger injected with something under high pressure

Is there any swelling or bruising?

Did you have swelling or bruising within 30 minutes of the injury?

Yes

Swelling or bruising within 30 minutes of injury

No

Swelling or bruising within 30 minutes of injury

Has swelling lasted for more than 2 days?

Yes

Swelling for more than 2 days

No

Swelling for more than 2 days

Do you have weakness, numbness, or tingling in your arm or hand that has lasted more than an hour?

Weakness is being unable to use the arm or hand normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness.

Yes

Numbness, weakness, or tingling for more than 1 hour

No

Numbness, weakness, or tingling for more than 1 hour

Do you suspect that the injury may have been caused by abuse?

This is a standard question that we ask in certain topics. It may not apply to you. But asking it of everyone helps us to get people the help they need.

Yes

Injury may have been caused by abuse

No

Injury may have been caused by abuse

Do you think the problem may be causing a fever?

Some bone and joint problems can cause a fever.

Are there red streaks leading away from the area or pus draining from it?

Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?

“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

No

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

Do you think you may need a tetanus shot?

Yes

May need tetanus shot

Have you had symptoms for more than a week?

Yes

Symptoms for more than a week

No

Symptoms for more than a week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Major trauma is any event that can cause very serious injury, such as:

  • A fall from more than 10 ft (3.1 m)[more than 5 ft (1.5 m) for children under 2 years and adults over 65].
  • A car crash in which any vehicle involved was going more than 20 miles (32 km) per hour.
  • Any event that causes severe bleeding that you cannot control.
  • Any event forceful enough to badly break a large bone (like an arm bone or leg bone).

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Pain in children 3 years and older

  • Severe pain (8 to 10): The pain is so bad that the child can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and sleep, but the child can tolerate it for hours or days.
  • Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

  • For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
    • You haven’t had a tetanus shot in the past 5 years.
    • You don’t know when your last shot was.
  • For a clean wound, you may need a shot if:
    • You have not had a tetanus shot in the past 10 years.
    • You don’t know when your last shot was.

With severe bleeding, any of these may be true:

  • Blood is pumping from the wound.
  • The bleeding does not stop or slow down with pressure.
  • Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

  • The bleeding slows or stops with pressure but starts again if you remove the pressure.
  • The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

  • The bleeding stops on its own or with pressure.
  • The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Finger, Hand, and Wrist Problems, Noninjury

Postoperative Problems

Cold Temperature Exposure

Finger Symptoms – Symptoms, Causes, Treatments

Finger symptoms include pain, numbness, weakness, stiffness, or problems moving the affected finger. Finger symptoms can result from damage or injury to any of the structures in the finger, including bones, joints, tendons, nerves, muscles, blood vessels, connective tissue, skin, or fingernails. The symptoms may be constant or variable and may improve or worsen with movement. If finger pain is present, it may be described as sharp, dull, stabbing, burning or throbbing, ranging in intensity from mild to severe. Sometimes, pain perceived in the fingers is actually referred pain that originates from injury or disease elsewhere in the body.

Depending on the cause, finger symptoms may be present in only one finger or even a small part of a finger, such as the nail or fingertip. Other conditions may affect all fingers on both hands. Arthritis and other types of degenerative joint disease are among the most common causes of finger symptoms, along with injuries and trauma. Deformities, either present at birth (congenital) or acquired later, can also cause finger symptoms. In other cases, finger symptoms may be related to a chronic underlying disease that affects other regions of the body. For example, bluish discoloration (cyanosis) and enlargement (clubbing) of the fingertips are characteristics seen in many chronic lung diseases in which the body does not receive adequate oxygen.

Diseases or conditions that affect the nerves and muscles, such as cerebral palsy and myasthenia gravis (a disorder causing muscle weakness), can be associated with symptoms that involve both the arm and the fingers. Disorders of the spine, such as infection, fracture, tumor, or disc disease, often produce symptoms in the arm and fingers. Infections of the cuticle (paronychia), skin and underlying tissue (cellulitis), or bone (osteomyelitis) are further causes of finger symptoms.

The duration and course of finger symptoms vary widely, depending on the cause. Symptoms caused by injury often have a sudden onset. In other cases, finger symptoms resulting from wear-and-tear damage develop slowly and persist or worsen over time.

The sudden onset of weakness or numbness in the arms or fingers, especially if it occurs on only one side of the body, can be a sign of stroke.
Seek immediate medical care
(call 911) if you have sudden weakness, paralysis or numbness in your fingers. 

If your finger symptoms are persistent or cause you concern,
seek prompt medical care.

90,000 Dislocation of a finger – causes, symptoms, diagnosis and treatment

Dislocation of the first finger of the hand

Can be dorsal and palmar, complete and incomplete. The displacement to the rear is formed during the extensor mechanism of injury, the displacement to the palm is formed during flexion. With dorsal dislocation, the long flexor tendon can be displaced and pinched between the articular surface of the proximal phalanx and the head of the metacarpal bone, making it difficult to reposition. At the time of injury, there is a sharp pain. The finger is swollen, deformed in the metacarpophalangeal joint.Active movements are impossible; when trying to passive movements, spring resistance is determined.

In dorsal dislocation, the finger is shortened, bent at the metacarpophalangeal joint and extended at the interphalangeal joint. The thenar area bulges out, the head of the first metacarpal bone is felt along the palmar surface, and the articular surface of the main phalanx is felt along the dorsal surface. With a palmar dislocation, the finger is extended in both joints and shifted to the palmar side. On the dorsum, the head of the first metacarpal bone is palpated. To confirm the diagnosis, an X-ray of the first finger is performed.If a long flexor tendon entrapment is suspected, an MRI or CT scan of the joint may be done.

Treatment of fresh toe dislocation is outpatient, carried out in a trauma center. Elimination of dislocation of the finger is performed under local anesthesia. With a dorsal dislocation, the traumatologist somewhat removes the finger and pulls it along the axis, while simultaneously shifting the proximal phalanx to the head of the metacarpal bone. The pull can be carried out using a bandage loop or using a conventional grip. In order to eliminate the entrapment of the tendon, the finger is turned to the elbow side, while bending the nail phalanx.After reduction, immobilization is carried out with a splint for 3 weeks.

If the dorsal dislocation cannot be reduced due to a pinched tendon, the patient is referred to the trauma department for open reduction. The operation is performed under local or local anesthesia using dorsal-beam access. The restrained capsule is dissected, the tendon is shifted to the side with the elevator, after which the finger is easily adjusted. The wound is sutured in layers and drained with a rubber graduate. Apply a splint for 3 weeks.The stitches are removed after 10 days.

Closed reduction of the palmar dislocation is also performed using axial traction. The finger is extended, extended and pressed on the head of the metacarpal bone, moving it to the palmar side. The immobilization period is 3 weeks. After reduction, for all dislocations of the finger, both palmar and dorsal, UHF is prescribed. The ability to work is restored in 4-5 weeks.

Dislocations of the proximal phalanges of the II-V fingers

Dorsal dislocations usually occur.The damage is accompanied by sharp pain, deformation, and swelling of soft tissues. Movement in the metacarpophalangeal joint is impossible, spring resistance is determined. On the palm, the head of the corresponding metacarpal bone is palpated, on the back – the articular surface of the main phalanx. The diagnosis is confirmed by radiography of the fingers. Outpatient treatment – closed reduction under local anesthesia followed by immobilization for 3 weeks. During this period, UHF and functional therapy are prescribed.The sick leave is closed after 4-5 weeks.

Dislocations of the nail and middle phalanges of the fingers

Usually dorsal, less often lateral. The patient is worried about a sharp pain. The finger is swollen, a bayonet-like deformity is revealed in the area of ​​the damaged joint. Movement is impossible. Sometimes the dislocation is accompanied by a tear of the extensor tendon, with the tendon usually torn away from the insertion site along with a small piece of bone. To confirm the diagnosis, an X-ray of the fingers of the hand is prescribed; if a tendon tear is suspected, the patient can be sent for CT or MRI of the bone.Treatment of uncomplicated dislocations is outpatient. The finger is adjusted under local anesthesia and a cast is applied for 3 weeks. Complicated dislocations are treated in a hospital. The damaged extensor tendon is sutured to the bone at the insertion site using transosseous sutures. The dislocation of the finger is adjusted, the wound is sutured. Immobilization is also carried out for 3 weeks.

The prognosis for dislocated fingers is favorable, in the vast majority of cases the range of motion is fully restored, there are no pains in the long-term period.Habitual dislocations of the fingers are extremely rare. Late seeking medical help can lead to the development of chronic dislocation. In such cases, simultaneous reduction is impossible; to restore the congruence of the articular surfaces, stabilize and develop the joint, the Volkov-Oganesyan apparatus has to be applied. The outcome of chronic dislocation can be arthrosis of the damaged joint.

Dislocation of toes

Dislocation of toes is a rather rare injury.Dislocations of the distal phalanx of the first finger are more often observed, the second place is occupied by injuries of the fourth finger, and the third finger is least often affected. Injury usually occurs as a result of indirect impact (hitting a hard object, falling from a height). There is a sharp pain, characteristic deformity, edema, limitation of function, shortening of the finger and a symptom of springy immobility. The diagnosis is confirmed by X-rays of the toes. Treatment is usually outpatient – closed reduction of toe dislocation. Manipulation, if possible, should be carried out before the onset of pronounced edema.Under local anesthesia, the traumatologist performs a longitudinal traction using a grip, gauze loop, or a thin wire passed through the distal phalanx. At the same time, the doctor presses on the base of the displaced phalanx in the opposite direction to the displacement.

If the dislocation cannot be eliminated, they resort to open reduction in a hospital setting. In case of instability, transarticular fixation with a wire is performed. In case of a single dislocation, a bandage consisting of several layers of adhesive plaster is sufficient for immobilization.With multiple injuries, it is necessary to apply a plaster cast. The patient is prescribed UHF. The fixation is continued for 2-3 weeks, the working capacity is restored in 3-4 weeks. The prognosis is favorable, in most cases the movements are preserved in full, the support does not suffer, there are no pains in the long-term period.

what to do, symptoms and treatment, first aid to the victim

Dislocation of a finger is a painful condition during which the articular surfaces of the bones of the victim are displaced.

The finger loses its mobility and functionality, it is turned towards the back or outer side of the palm, sometimes lateral dislocation occurs.

With complete dislocation, the ligaments are torn and contacts between the surfaces of the joints are lost. In most cases, traumatologists are faced with injuries to the thumb and forefinger, in 15 – 18% of cases, the remaining fingers are affected.

Causes of dislocations

The main reason for dislocation of the thumb is force, which in its intensity is much stronger than the ability of the ligaments to stretch.Usually, this problem manifests itself as a result of very rapid flexion and extension of the fingers. Also, injury can appear when falling on a straight arm, when hitting something hard.

Dislocations of the joints of the fingers are noted when the knuckles come out. The risk group includes sports fans who prefer extreme sports. Non-professional risk groups include fights and falls. For boxing fans, this problem can occur even with protective equipment. Exercising at home greatly increases the risk of a dislocated thumb.

In addition to boxing, provoking factors are:

  • falling on the wrist;
  • diseases of the musculoskeletal system such as osteoporosis, osteomyelitis;
  • pressing down the phalanx with a heavy object;
  • door finger pressing;
  • Excessive fragility of bone tissue.

The risk group also includes elderly patients, as well as patients with multiple hand injuries in the history of the disease. As soon as symptoms of a dislocated finger appear on the hand, it is necessary to urgently consult a traumatologist.Only a specialist will be able to determine the severity of damage to the phalanx. Only the doctor knows how to adjust the finger on the hand. A seemingly insignificant injury can provoke a number of complications.

Classification

A condition in which a bone or joint is displaced is dangerous and requires treatment. There are several types:

  • Congenital, appears even at the intrauterine stage, due to the underdevelopment of the surface of the joints. It is characteristic of the hip region;
  • Traumatic type, characterized by injuries when the joint capsule breaks.Complicated traumatic displacements accompanied by damage to bones, blood vessels or muscles are less common. If the skin is torn, then the dislocation is classified as open;
  • Habitual. This type is typical for persons with a weak or already damaged joint capsule, it can occur even with awkward movement;
  • Pathological, typical for persons with diseases of the periarticular tissues.

According to the degree of displacement, complete and incomplete dislocations are distinguished. Incomplete, or subluxation, is a condition in which the articular ends touch, with complete dislocation, completely diverge.

Symptoms

Symptoms of a dislocated finger on the hand are always pronounced. A person has external manifestations and extremely unpleasant sensations that bring discomfort. The pain is severe, which often becomes the root cause of traumatic shock. Signs of a dislocated finger will depend on the type of injury.

The following manifestations accompany the knocked-out knuckle:

  • tissue edema and swelling;
  • the appearance of hematoma, cyanosis, hemorrhage;
  • dumbness, feeling of running creeps;
  • throbbing pains of varying intensity;
  • difficulty moving;
  • partial retention of the ability to work;
  • noticeable deformation;
  • limitation of mobility.

After an injury, a person cannot move a finger, so absolutely any movement provokes severe pain and an increase in swelling. The injured area becomes reddish. In this situation, the surrounding dermis acquires a pale shade. This is due to circulatory disorders. The dermis is hot to the touch and turns purple very quickly. Dislocation or sprain of the finger must be supervised by a specialist.

Varieties of dislocations

A dislocation of the thumb on the hand can be observed towards the palm, in the opposite direction.In this case, various combinations of rupture of the supporting ligaments can be noted. In most cases, there is a pronounced curvature, swelling and soreness are noted.

Dislocations to the back side

Injuries to the back side are noted due to overextension of the finger. Sometimes injuries are accompanied by a shift of the palmar structures into the joint. In case of damage to the palmar plate, a small fragment of bone, separated from the middle phalanx, is sometimes noted on an x-ray.

Dislocation of the little finger on the hand to the back is adjusted by pulling the joint along the axis and applying force from the palmar side.If there is any suspicion of damage to the palmar plate, or if closed reduction is not possible, then postcards will most likely be required.

Lateral dislocations

Lateral injuries can appear when an abductive or adductive force is applied to an extended finger in the joint. With this type of injury, severe soreness and instability appear. The joint is repositioned and then shunted at an angle of 35 degrees.

Dislocation to the palmar side

Palmar injuries are usually rare and appear when force is applied to the rotated finger joint from the inside.Most often, there is a rupture of the central part of the extensor tendon, provoking a curvature like a bud.

Dislocation in the palmar side is adjusted using axial traction and applying force from the back, and then shunted for 7-14 days. As a result, patients should be examined to determine if surgery is necessary to repair the torn central part of the extensor tendon.

Diagnostics

Traumatologist examines the damaged joint, specifies the details of the injury, how the injury occurred.
The patient is then given an X-ray and a diagnosis is made based on the data.

The doctor prescribes treatment and sets the joint in place . In some cases, the doctor prescribes an MRI, this is necessary if the patient has a suspicion of an infringement of the joint.

First aid

Many people wonder what to do if a finger is dislocated on the hand. It is very important for the patient to provide first aid so as not to provoke complications and deterioration of the condition. In case of injury to the hand and finger, a number of measures should be performed, and then urgently consult a traumatologist.It is very important to immobilize the limb and relieve pain.

Once you recognize the symptoms of a dislocated finger, proceed as follows:

  1. Keep your hand at rest. This will help not to aggravate the situation and prevent inflammation.
  2. Apply a cold compress to injured fingers to relieve swelling and soreness.
  3. Place a cotton wool roll between the affected and healthy fingers.
  4. Rewind your finger, but be careful not to pinch it too tightly.
  5. Be sure to use an analgesic.It can be Ketanov, Analgin, Nurofen.
  6. Be sure to contact the nearest emergency room.

Upon arrival at the medical institution, it is imperative to tell the doctor all the circumstances of the injury, the symptoms of a dislocated thumb, all the sensations. The doctor will diagnose and be able to make an accurate diagnosis. Only after this can a competent treatment of the dislocation of the fingers be prescribed.

Dislocation of a finger in a child

The incidence of such injuries among children is due to increased physical activity, thin fingers and weak ligaments.Severe pain causes panic in both the child and the parents. The primary goal is to calm down yourself, calm the child and fix the hand with the help of available means.

Next, apply a cold compress to prevent the development of puffiness and take care of the prompt delivery of the victim to the emergency room.

Leave attempts at self-reduction, otherwise you can only aggravate the pathology.

With regard to panic, it will be much easier for a child to calm down and cope with pain if he does not observe how adults worry and panic.Pretend that nothing terrible has happened, and convince the child that the doctor can fix everything.

Methods of therapy

Only an experienced specialist will know what to do in case of a dislocated finger, and how to quickly deal with the problem. Reduction of dislocated joints is a rather painful procedure, therefore, traumatologists carry out this procedure only under anesthesia. Depending on the type of injury, the doctor treats the sore finger with different methods.

If the injury is uncomplicated, then the doctor can correct the dislocation of the finger by gently pulling the end of the finger until it clicks.At this moment, the joint returns to its original position. To get rid of puffiness and pain after this procedure, the patient is prescribed analgesic ointments such as Diclofenac, Dolobene and others.

If, during the procedure, the patient’s digital ligaments are torn or even just stretched, then the specialist directs the person to the operation. Also, intervention is indicated if more than 7 days have passed after the shift, and there was no competent solution to the problem.After the intervention, the surgeon applies a plaster cast for 2-4 weeks. Such fixation guarantees the correct fusion of all ligaments and muscles.

If a person did not go to the doctor in a timely manner and did not correct the dislocation of the middle finger, then a false finger joint occurs. In this case, intervention is also indicated and the specialist gives the previous shape not only to the finger bone, but also to the connecting articular apparatus. Also, the specialist prescribes a set of physiotherapeutic procedures. That is, with a prompt visit to a doctor, the treatment of a dislocation of the middle finger takes place as quickly as possible and without complications.

Closed reduction

Once the thumb is dislocated, the finger should be adjusted. The person must go to a hospital where the doctor performs an effective closed reduction of the displaced joints. In addition, the person undergoes outpatient therapy. If possible, manipulation is carried out until severe swelling appears.

In closed reduction of the index finger dislocation, the specialist firstly anesthetizes the deformed limb with local anesthesia. The intervention is performed under conduction anesthesia.After that, the doctor stretches the damaged joint along its length. With this manipulation, the professional uses a surgical grip, a gauze loop and not a thick knitting needle. It is passed through the distal phalanx of the finger.

In parallel with this, the doctor presses on the diseased phalanx in the direction opposite to the shift. As a result, the joint successfully returns to its original position.

Open reduction

If the doctor failed to correct the dislocation of the phalanx of the hand on an outpatient basis, then he sends the person to the operation.Only a professional knows how to correct a dislocated finger. In case of manifestation of instability, the specialist performs transarticular fixation of the human hand joint. The doctor immobilizes the limb with a bandage, which consists of an adhesive plaster.

If multiple dislocations were obtained, the specialist applies a plaster cast on the affected limb. After that, the performance of UHF is shown without fail. Gypsum is removed after 2-3 weeks, and absolute mobility is noted after 3-4 weeks.The prognosis for open reduction of the affected toe is usually good. Most often, after therapy, all hand motility is restored in full.

Treatment of dislocated fingers

Diagnosis is carried out using an X-ray, after which a decision is made about surgical intervention. If the injury is simple, and the dislocation occurs in the middle joint, the finger is immobilized with a plaster cast, and the patient is sent home. If it is necessary to correct the joint to restore the functions of the ligamentous apparatus, this is done as soon as possible to avoid complications.When adjusting, local anesthesia is usually applied. The traumatologist pulls the injured finger until it clicks. By the degree of prescription, the dislocations are divided into:

  • fresh – the injury occurred no more than two days ago;
  • stale – the injury occurred no more than a month ago;
  • habitual – the same joint is damaged regularly;
  • old – more than a month has passed since the injury.

By the nature of the damage, there are dislocations:

  • open – with a rupture of the skin;
  • closed – without rupture of the skin;
  • irreducible – soft tissues are clamped between the articular surfaces of the bones;
  • complicated by pinched nerve endings, fractures, rupture of large vessels.

Dislocations more than a month old are often complicated by the formation of false joints and incorrect functioning of the ligamentous apparatus. During treatment, old dislocations require an operation under local anesthesia, during which the surgeon reorganizes the position of the bones relative to each other, so that the joint capsule is subsequently restored to the anatomically correct position. For dislocations complicated by ligament rupture or fracture, surgery is also performed. Recovery time depends on the characteristics of the injury.When a dislocation occurs, a sprain or rupture of the ligaments may occur, and if a rupture occurs, healing will take longer.

In difficult cases, instead of plaster, Beler’s wire splint is applied, after removing which the patient is prescribed a course of therapeutic massage, physiotherapy and gymnastics. Simple dislocations heal from two weeks to a month, complicated ones – from a month to two. After removing the plaster splint, the patient is also advised to knead the finger with the help of special therapeutic exercises. Exercises, selected by the orthopedist in each case, contribute to the early restoration of the motor functions of the finger.In order not to have difficulties with the mobility of the finger and there were no subsequent chronic pains and dislocations, it is important to take a responsible attitude to remedial gymnastics, perform all exercises and not overload the recovering finger. At first, broad-spectrum ointments are prescribed to relieve puffiness and pain.

Medicines for dislocation

Each patient asks himself what to do if his finger is dislocated. The first step is to visit a specialist who will diagnose.Only after this will competent therapy be prescribed. Doctors prescribe various creams and ointments that promote quick restoration of joints, elimination of pain, acute inflammatory process.

Considering what to do if the dislocation of the finger on the hand is uncomplicated, you should pay attention to the following drugs:

  1. Traumeel C . This is a popular drug that is included in the complex treatment of dislocations. The medication is characterized by anti-inflammatory, decongestant, analgesic, immunostimulating and wound healing effects.The drug improves local blood circulation, thereby stimulating rapid healing. After application, the swelling decreases.

  2. Dolobene . This is a combined product for external use. The main component is dimethyl sulfoxide. It is characterized by anti-edema, anti-inflammatory and local analgesic effects. Heparin is characterized by anti-inflammatory action, and also helps to restore connective tissue.Dexpanthenol in the composition speeds up the healing process. When applied, itching, irritation, redness may appear. The remedy is contraindicated in children under 5 years old, pregnant women, nursing mothers.
  3. Arnigel . The drug is made on the basis of arnica. It is prescribed to reduce bruising. The medication is contraindicated in the presence of abrasions on the skin, for children under one year old.
  4. Finays Gel . The drug contains a complex of essential oils and natural ingredients: eucalyptus oil with analgesic and anti-inflammatory properties.After applying the composition, the gel first has a cooling effect, and then gradually warms up. The medication fights tension, soreness, fatigue, muscle cramps. Also, the drug helps to reduce inflammation and swelling of the joints that occur with dislocations. The ointment is contraindicated for pregnant women, nursing mothers and children under 12 years of age.
  5. Badyaga (powder for suspension). It is a locally irritating preparation, which is obtained from the freshwater sponge of badyagi.The action is based on mechanical irritation of the dermis due to the content of silicon needles. Badyaga enhances blood flow to cells, renews their nutrition and respiration.
  6. Deep Relief . An effective gel characterized by analgesic, antiphlogistic effects. It penetrates very quickly into the lesion.
  7. Finalgel . The active ingredient is sodium heparin. It is characterized by antiphlogistic, antiexudative local anesthetic effects.Promotes the regeneration of damaged connective tissues.
  8. Mataren Plus . An effective cream, the active ingredients of which are meloxicam and capsicum extract. It is characterized by analgesic, antiphlogistic, decongestant effects.
  9. Dr. Theiss . Broad-spectrum ointment, the active substance of which is comfrey. It is characterized by a local analgesic effect.

Also, doctors often prescribe ointments with steroid hormones, since they are able to suppress the acute inflammatory process.Also, such agents reduce the permeability of the vessel walls. This already prevents the formation and progression of edema. Ointments with snake and bee venom in the composition are excellent for treatment.

Ointments with a cooling effect will help to quickly improve the patient’s condition. These include those that contain menthol. It cools and fights pain. After an injury, you can use a cooling spray instead of an ointment.

The most effective means are ointments with non-steroidal anti-inflammatory substances.They penetrate directly into the focus, and begin to fight inflammation, soreness, swelling. With the help of such means, it is possible to very quickly restore the mobility of the joint. Before using any product, you should consult your doctor. This will avoid unwanted consequences.

What to do in case of dislocation

Many people wonder what to do if a finger is dislocated. But it is also important to know what to do is strictly prohibited in order not to provoke complications.Suspecting a dislocation, it is strictly forbidden to do the following:

  1. Do not hope that everything will spontaneously work out . Dislocation is the closest relative of a fracture. Even if the bone tissue is intact, then vessels and nerves may suffer if it is displaced. Perhaps all this will heal, but after years the injury will remind of itself with aching pains. Limitation of mobility may also occur.
  2. Do not try to correct the dislocation yourself . Many, knowing what a dislocated finger looks like, try to straighten it spontaneously at home.But doing this is strictly prohibited. First of all, a person may not have a dislocation, but even a fracture. Symptoms of a dislocated index finger are very similar to those of a fracture. It is possible to distinguish one injury from another only thanks to radiography. Trying to straighten broken bones on your own can only aggravate the situation.
  3. Do not brake . Trauma is always accompanied by swelling, and often also an internal blood flow. The more time passes after the injury, the more fluid accumulates near the joint and the more difficult it is to correct the diseased joint in the future.In no case should you hesitate after an injury, but you should contact the emergency room as soon as possible.

First Steps

Here are some important tips:

  1. Avoid any wrong action, trying to adjust the joint yourself. Any slight incorrect movement leads to the fact that the bone either grows together, or stretches, or aggravates the general situation.
  2. Rings are removed whenever possible. It must be securely fixed and free from any unnecessary movements.This will help avoid any other injury. So the situation will not worsen even more. A bandage is used as a retainer. But don’t tie it too tightly.
  3. It is important to cool the damaged area slightly with something cold.
  4. Pain medication should be taken as needed.
  5. The patient is taken to the hospital as soon as possible to be examined by a traumatologist. Sometimes there is a need to call an ambulance.
  6. During the doctor’s appointment, the damage is examined.You can determine exactly what the nature of the disease is: dislocation, sprain or fracture. If a dislocation is determined, then the doctor can correct it manually. It is forbidden to do it yourself.

Why is it important to treat dislocations right away

Not many people know what to do if a thumb dislocation occurs and why it is important to start treatment right away. If the joint is not inserted in a timely manner, then it will remain deformed. As a result, the functional ability of the limb will be changed and the person will not be able to perform the volume of actions to which he is accustomed.

Old injuries, which were received more than 2-4 weeks ago, are no longer subject to conventional classical treatment. The head of the joint moves and pinches the soft tissue. That is why it is possible to correct the dislocation of the thumb on the hand only thanks to the operation.

If a dislocation of a finger on a child’s hand appears due to a blow or a fall, then soft tissues are very often affected. Without proper therapy, the likelihood of wound infection is extremely increased. With correctly selected therapeutic measures, a person is very quickly recovering.

Over time, soreness disappears, swelling decreases, and the mode of motor activity gradually expands. The restoration of the lost abilities continues for a month. During this period, doctors prescribe analgesics. They cope not only with pain, but also eliminate all signs of an acute inflammatory process, as well as puffiness.

What is the danger?

Contrary to popular and fundamentally mistaken belief, this injury is very serious.After all, if the dislocation is not treated, the likelihood of developing very unfavorable and undesirable complications increases:

  1. Disturbance of trophism, followed by atrophy and loss of functionality of the injured finger.
  2. Damage to nerve endings, fraught with loss of sensitivity and even paralysis of the finger.
  3. Development of inflammatory processes localized in the joint area.

In case of this injury, the victim needs adequate, professional treatment! Therefore, it is important to recognize the characteristic clinical signs, skillfully provide first aid and promptly deliver the patient to the emergency room!

Complications and consequences

If there is a dislocation of the index finger, the finger is deformed, severe pain and swelling occur.If you do not start competent therapy, then the risk of complications increases significantly. Open injuries are especially dangerous when infections, including life-threatening tetanus sticks, can enter the wound.

You may encounter the following possible complications:

  • loss of retention function;
  • regular aching pains, aching joints;
  • joint inflammation and arthrosis;
  • joint stiffness;
  • weakness of the tendons;
  • Modification of the shape of the finger.

With proper treatment of the dislocation of the finger on the hand, the prognosis is positive. Dislocated toe recovery occurs within a month. If unpleasant sensations appear, then it is worth visiting a specialist.

A little bit of anatomy

The fingers are the end of the hand. Experts designate them with Roman numerals:

  • I – large;
  • II – index;
  • III – medium;
  • IV – unnamed;
  • V – pinky.

Each finger has a dorsal, palmar, and two lateral surfaces.

All fingers of the hand, except for I, consist of three phalanges:

  • proximal (main) – located closer to the hand;
  • distal (nail) – located at the end of the finger;
  • middle – located between the proximal and distal.

I finger consists of two phalanges.

The phalanges are interconnected by joints, and to the hand they are attached to the heads of the metacarpal bones, forming the metacarpophalangeal joints.

Rehabilitation after dislocation

Every victim wants to know what to do in case of a dislocated finger.It is very important to pay attention to rehabilitation. Measures during the recovery period are aimed at preventing deformation changes in the phalanges and hand. For this, special exercises, special care, physiotherapy, and also some methods of alternative medicine are shown. But it is very important to listen to all the advice of experts.

Physiotherapy for finger restoration after dislocation includes:

  • electrophoresis;
  • laser therapy;
  • ultrasound;
  • ultraviolet irradiation;
  • electrostimulation;
  • UHF therapy and other methods.

The objectives of physiotherapeutic procedures are to restore natural mobility, enrich the affected tissues with oxygen, improve metabolic processes, and pain relief.

Physiotherapy means:

  1. Ultraviolet radiation . This procedure lowers the sensitivity in the affected area and fights soreness. Also, radiation promotes the production of vitamin D3 in the body, which is extremely important for the absorption of calcium.It is important for the musculoskeletal system. UFO supports metabolic processes in the joints of the fingers.
  2. Electrophoresis . The procedure is the introduction of medicines into the thickness of the muscle tissue by the action of an electric current. Thanks to the procedure, blood flow in the joints of the fingers is accelerated, the acute inflammatory process, soreness and swelling are eliminated. Electrophoresis facilitates the passage of seizures and spasms. Usually, the procedure has a prolonged therapeutic effect.
  3. Laser therapy . This type of treatment is aimed at eliminating inflammation, soreness, and improving the restoration of the sprain of the thumb on the hand.
  4. UHF . The procedure involves exposure of the joints to ultra-high frequency waves. This method helps to cope with severe pain, acute inflammation and swelling. But this method is contraindicated in the case of hypertension.
  5. Ultrasound .This method enhances the absorption of hormonal ointments and other external agents. The method is prohibited for angina pectoris.
  6. Acupuncture . This method is based on responses to a stimulus. The needles are inserted into bioactive points on the fingers. Thanks to manipulations, you can cope with pain syndrome, as well as improve muscle tone.
  7. Phonophoresis . This is an analogue of electrophoresis, but drugs are administered by exposure to a sound wave. Strengthens the effect of medications and stimulates the restoration of joints.
  8. Balneotherapy . Healing baths and water procedures normalize blood circulation, metabolic processes, tissue trophism. The method also stimulates regeneration, reduces pain and fights inflammation.
  9. Mud therapy . Various baths, applications and wraps have both mechanical and thermal effects. Mud nourishes tissues with beneficial bioactive substances and minerals. Their healing effect is aimed at eliminating the acute inflammatory process and soreness.

It is very important to follow all the instructions of a specialist so as not to aggravate the situation and not provoke the development of complications.

Remedial gymnastics after dislocation

Many people wonder what to do if the thumb is dislocated. Doctors advise starting therapeutic exercises, which will help restore joint mobility. A set of useful activities must be performed three times a day. Each exercise is repeated 10 times.

Exercise therapy includes the following:

  1. Rub the hands to start feeling warm.
  2. Put straightened fingers into the shoulder blade and rotate in the hands.
  3. Put the upper limbs on a table or other horizontal surface, palms down. Unfold the hands without lifting them from the table, raising their palms up and returning them to their previous position.
  4. Place the hands again on a horizontal surface, performing rotational movements with the hands, without lifting them from the table.

In addition to basic exercises, it is very important to do activities that help develop fine motor skills.These are:

  • folding the constructor or puzzles;
  • typing on the PC keyboard;
  • to collect scattered matches or grains on a flat surface;
  • to be engaged in sewing, knitting, appliqué;
  • play keyboard instruments;
  • Train your arm with an expander.

Also in case of complicated subluxation of the thumb, it is necessary to add a number of therapeutic exercises:

  1. Squeeze your hand into a fist and try to light an invisible lighter.
  2. Squeeze the hand in a fist so that the thumb is in it. Turn the palm side up.
  3. Relax the limb completely and try to reach the tip of the thumb with each finger.
  4. Place your hands on a flat horizontal surface, palms down. Collect your fingers in such a way as if you need to salt something. Then return the fingers to their original position.

The course of exercise therapy is indicated for:

  • to improve blood flow in the affected area;
  • resumption of muscle activity;
  • joint mobility adjustments;
  • improvement of the general condition;
  • Development of Flexibility Bundles.

Each patient is more often selected an individual set of exercises.

Are folk remedies necessary

Considering what to do at home with a dislocated finger, it is worth paying attention to grandmother’s recipes. The following effective recipes are worth considering:

  1. Take bryony root, finely chop and pour in a liter of water. Boil the broth for a quarter of an hour. There is no need to wait until the product has completely cooled down. In a warm composition, moisten a bandage and apply to the affected area.
  2. Take the perestroot roots, grind them and mix them with oil. The result is a healing gruel. She will need to lubricate the affected area several times a day.
  3. Take elecampane roots, pour a glass of boiling water and leave for 40 minutes. In the resulting composition, moisten a piece of bandage and apply to the affected area. This application stimulates the process of repairing damaged tissues.
  4. Finely chop the baked onion and mix with sugar. Apply such gruel to the affected area and rewind with a bandage.It is recommended to apply the application before bedtime.
  5. Common Agrimony . Take 3 large spoons of dry common agaric and pour 2 cups of boiling water over. Put on low heat for a third of an hour and filter. As a result, add water to the original volume. Use the resulting product as an application for dislocations, stretching the little finger on the hand or other fingers.
  6. White step . Take a small spoonful of powdered dry root of a plant and mix with half a glass of vegetable oil.After repositioning, treat the affected area with the received medication.
  7. Ordinary cuff . Knowing what a dislocation of fingers looks like on a hand, you must immediately use an ordinary cuff for treatment. Take 100 g of plant leaves and pour 0.5 liters of boiling water. Leave the composition to infuse for 4 hours, then filter and make compresses from the infusion. Apply applications for half an hour to the affected area. Such a remedy is characterized by a hemostatic effect and kills microbes.
  8. Lavender . Add 1 part lavender herb and flowers to 5 parts sunflower oil. The remedy should be infused for several months. Use the resulting lavender oil as an analgesic.
  9. Black poplar . Take half a glass of dry kidneys and pour a glass of boiling water. Leave the composition to infuse for half an hour. Apply the resulting mass in the form of an application daily to the damaged area.
  10. Twisted cornflower . 3 teaspoons of twisted cornflower flowers pour 0.5 liters of boiling water, leave to infuse for an hour, and then filter.Drink the resulting broth in half a glass three times a day. This recipe is an effective remedy for dislocations.
  11. Barberry . Pour a glass of milk into a saucepan, add half a spoonful of chopped branches, bark and roots of barberry. Boil the product for half an hour and then filter. Consume 1 small spoon three times a day.
  12. Hot milk . Traditional healers for dislocations advise hot milk applications. Take cheesecloth, roll it in four and soak in hot milk.Apply gauze to the affected area, and apply compress paper and cotton wool on top. Change the application as the gauze cools.

A variety of applications, herbal teas help in the treatment of a wide variety of injuries. That is why everyone should know how to treat a dislocated finger using such means.

Treatment of a dislocation of the middle finger at home necessarily includes:

  1. It is necessary to prepare a hard dough and attach it to the affected area.This application will help eliminate the acute inflammatory process and swelling.
  2. Grind cornflower flowers and pour boiling water over them. Let the broth brew for half an hour, then filter and cool. The broth is used internally. Drink three times a day.

Recently, folk remedies for the treatment of dislocation of the middle finger have become very popular. But everyone should understand that such funds should be included in the complex treatment, since individually they are ineffective or give only a temporary result.With the help of herbs it is possible:

  • to reduce pain;
  • to cope with the acute inflammatory effect;
  • Relieve the victim from the state of shock.

But as soon as a person develops all the signs of subluxation of a finger, then you should immediately consult a doctor. This will significantly reduce the time of human suffering, as well as accelerate the rehabilitation of the joint and return to normal life. After removing the plaster cast, various herbal ointments are used to help restore finger mobility.

Preventive measures

Unfortunately, to date, the rules and safety measures in sports clubs, schools, fitness complexes are not given due attention, therefore, care for the safety of their health, entirely and completely, lies with each person personally. It is best to take care of personal protective equipment yourself during sports – wear special non-slip shoes, comfortable clothes, and do not use unnecessary objects on your fingers during training.

It will not be superfluous to get information about the types of first aid for dislocations as self-education.

Preventive measures

In order not to wonder how to know if you have a dislocated finger, and how to fix this problem, it is very important to simply adhere to preventive measures. The basic rules for the prevention of dislocation of a finger on a hand in a child or an adult are:

  • observance of safety rules;
  • correct power supply;
  • giving up addictions;
  • Compulsory warm-up before training.

It is very important to see a doctor immediately after injury. This will reduce the risk of progression of relapses, complications, and will also help to carry out competent therapy.

A dislocated toe is a painful injury that causes discomfort. If the problem is not treated in a timely manner, a number of complications can be provoked. Knowing how to determine a dislocated finger on your hand, you need to urgently consult a doctor. Only an experienced specialist will be able to make an accurate diagnosis, if necessary, carry out additional diagnostic procedures and prescribe a competent therapy regimen.

Length of the recovery period

How long and difficult the treatment will be depends on the following:

  1. How severe the injury is.
  2. How timely and efficiently the first aid was provided.
  3. How soon they went to see a doctor.

In any case, reduction is necessary, which is sometimes done with local anesthesia. Then the specialist fixes the hand securely so that the patient is comfortable. There are orthoses to help keep you still.Pain is reduced, no accidental displacements occur.

This will help the patient to quickly normalize the condition of the injured fingers. In order to accelerate rehabilitation after setting the finger and applying a bandage, they use the use of local remedies, ointments. They must have anti-inflammatory, analgesic and decongestant effects.

We recover quickly (within 2-3 weeks):

  • Undergoing physiotherapy procedures.
  • Passage of therapeutic massage.
  • Availability of a special set of exercises.

The faster treatment is started, the faster the injured limb will function normally.

Dislocation of the finger on the hand: symptoms, first aid, treatment

Dislocation of the finger on the hand is accompanied by a displacement of the bone involved in the formation of the joint, which leads to a violation of the integrity of the joint capsule. In this case, a rupture of the ligaments that hold the bones and muscles together occurs, and the bone element can come out of the articular capsule (bag).

Ligament rupture accompanied by joint displacement indicates complete dislocation. When the ligaments are stretched, subluxation is diagnosed.

Dislocation of the thumb is one of the most frequently recorded hand injuries. Injury can occur after a strong blow, during a fall or with a firm handshake, during sports or careless movements.

The damage is not dangerous to life or health, but it is accompanied by severe pain, therefore it is considered serious and requires the help of a specialist.

Structure

Fingers each have 3 phalanges, interconnected by block-like joints. The phalanges are called proximal (longest), middle and distal (shortest, with nails). Depending on the damaged phalanx, dislocations of the limbs of the hand are divided into:

  • Main.
  • Medium.
  • Nail.

And only on the thumb there are two, there is no middle phalanx. The joints closest to the palm are formed by the metacarpal tubular bones, which are attached to the proximal phalanges.Ball joints are located at the attachment points. Thanks to them, a person can bend and unbend his fingers.

The structure of the thumb:

  1. Articular cartilage, connective (collagen) tissue, circulatory system and nerves are located between the bones.
  2. The thumb joint has a saddle shape.
  3. All joints of the hand have an articular capsule (bag) – a hermetic cavity consisting of a synovial and fibrous layer. The capsule is attached to the ends of two adjacent phalanges, and serves to reduce friction of the articular surfaces.

The ligamentous apparatus is located above the capsule. It allows the limbs to move without injury within the physiological norm.

Ligaments of fingers are called collateral. Sometimes a dislocated finger provokes their rupture.

Fingers in medicine are designated each in order by Roman numerals from I to V, starting with the big one and ending with the little finger. All of them, except for the large one, are arranged in the same way.

Dislocations of the proximal phalanges

Dislocation of the little finger, ring, middle and index fingers in the region of the proximal phalanges often occurs towards the back of the hand.At the same time, it is extremely difficult to move them – an attempt to move meets springy resistance. When palpating the palm, the top of the metacarpal bone is felt, and the articular surface of the phalanx is palpated on the back.

If soft tissues are caught between the articular surfaces, and they are clamped, the dislocation is called irreducible.

Dislocations of the middle and distal phalanges

When a finger is dislocated in the region of these phalanges, dislocations to the outer side of the hand are often recorded, sometimes lateral. The joint is deformed, sometimes a rupture of the ligaments occurs, often the tendon breaks off from the bone together in its part.Movement is difficult. Damage is called habitual if it is repeated at the same place repeatedly.

Dislocation of the thumb

Dislocation of the finger joint to the outer side of the hand appears in the case of the flexion mechanism of injury, to the inner one – during the extension. The dorsal can cause displacement and pinching of the tendon between the proximal phalanx and the metacarpal bone, which will greatly prevent it from returning to its previous position. The trauma is extremely painful.After dislocation, with a slight movement of the injured limb, it is slightly springy, normal movements are impossible.

Injuries are said to be open if the skin and soft tissues are damaged. The integrity of the skin accompanies a closed injury.

The thumb is deformed more often, as falling, the person protects the chest and transfers the weight of the body to the exposed finger.

Symptoms and Diagnosis

Symptoms of a finger dislocation are quite definite.At first glance, it is not difficult to diagnose an injury – it is accompanied by signs:

  1. Deformation of the damaged joint with displacement.
  2. Sharp pain.
  3. Skin redness.
  4. Pallor and numbness.
  5. Progressive edema.
  6. Inability to flex and extend the injured limb.
  7. Fever at the site of the dislocation.
  8. Ligament rupture sometimes occurs.

Despite the obvious signs of the disease, the diagnosis must be made by a specialist.Do not self-medicate, because instead of a dislocation, an X-ray can also show a fracture of the finger.

The diagnosis is usually carried out by the trauma doctor:

  • First, he determines how much time has passed since the injury. It is considered fresh up to 2 days, from 1 to 4 – stale. If more than a month has passed, then this is a chronic injury.
  • Visual inspection and palpation of the hand will provide information about the changed position of the external joints. A sprained thumb causes pain around the affected area and pain when the thumb is pulled to the left and right.
  • Suspected dislocation of the phalanx of the toe requires a 2-plane X-ray to determine the presence or presence of fractures.

If the dislocation is complicated and there is a rupture of the ligaments, the doctor may additionally prescribe a computed tomography or magnetic resonance imaging.

First Aid

Severe pain that accompanies an injury requires immediate first aid. Having knowledge of what to do in case of dislocation, you can significantly alleviate the condition of the victim by providing first aid for dislocation or fracture.

How to provide:

  1. First, you need to free your hand from excess clothing and jewelry, bend the sleeves.
  2. The limb should be in an elevated position so as not to provoke excessive blood flow to the injury site.
  3. Then you need to apply ice to your hand or (if not available) a towel, previously left in cold water for about 20 minutes.
  4. Damaged tissue is treated with an antiseptic.
  5. To prevent further displacement of the joint, it is secured with a tight bandage until a doctor’s examination.
  6. Anesthetic can be given.
  7. It is required to immediately transport the victim to the hospital.

The joints cannot be adjusted on their own – this can cause disastrous consequences. In addition, a splint / bandage is sometimes required.

Treatment

Only a doctor should treat sprains and sprains of fingers. Reduction is painful and cannot be done without local anesthesia.

There are many treatment methods, they are selected by specialists depending on the side to which the finger is dislocated:

  1. An uncomplicated dislocation is adjusted by gently pulling the tip of the limb until a characteristic click, which will indicate that the joint has taken the correct position.To relieve swelling and pain, pain relieving ointments (Diclofenac, Dolobene and others) may be prescribed.
  2. Dislocation complicated by sprained or torn fingers may require surgery. Also, operations are carried out in cases where more than 7 days have passed after the injury, and there was no reduction. The operation ends with the application of a plaster cast or splint for a period of 2 to 4 weeks. The need for fixation is due to the fact that the stretched or dislocated finger must heal properly.
  3. If the reduction was not performed in time, the formation of a false joint may occur. Then you cannot do without an operation – you will need not only to restore the bone itself, but also the connecting apparatus.

Physiotherapy procedures are additionally prescribed at the discretion of the doctor.

With timely referral to a traumatologist and his correct actions, the injury goes away, complications are not observed.

Rehabilitation

Healed injuries in the phalangeal part of the hand must undergo a rehabilitation course to consolidate the results of treatment.It usually lasts up to 6 weeks. Efforts are directed at fixing the joint, relieving pain, eliminating inflammation and strengthening.

The course of exercise therapy is prescribed for:

  1. Normalization of joint mobility.
  2. Improve blood flow in the affected area.
  3. Development of the flexibility of the bundles.
  4. Resumption of muscle activity.
  5. General health improvements.

Each patient is developed their own set of exercises, based on the type and condition of the trauma.

  • Additional physiotherapy treatments may include:
  • Ultrasound treatment.
  • Exposure to UV and infrared rays.
  • High frequency magnetotherapy.
  • Laser therapy.
  • Treatment with a weak impulse electric current.
  • Electronarcosis.

Massage is a good remedy. It should be carried out only after removing the plaster and with an individual selection of exposure techniques.They begin with 5-minute sessions, within 14 days, their duration is increased to 20 minutes. Before the massage, the affected area should be well warmed up.

At home, you can use traditional methods of treatment:

  1. A steep dough is kneaded from 9% vinegar and flour, which is applied in the form of a compress to the sore spot to relieve inflammation.
  2. Baked onion grated with sugar 2 times a day is applied to the joint in the form of lotions.
  3. The crushed roots of the perestroika can also be mixed with sunflower oil, the composition is rubbed into the affected area 5-6 times a day.
  4. Compresses at night can be made from warm milk. Woolen gloves or mittens are worn on top of the compress.

The treatment will restore the integrity of the dislocated fingers of any hand. To prevent the joint from dislocating later, it must be fixed with an elastic bandage for any additional loads (for example, when playing sports).

Dislocation of the finger of the hand: symptoms, signs, diagnosis and treatment

Description

Fingers are
the end of the hand, while all fingers are indicated with
use of Roman numerals and have their own names – thumb (I),
index finger (II), middle finger (III), ring finger (IV), and of course,
little finger (V).Also on the finger is the back, palmar, inner and outer
side, while the nails are located directly on the back surface.

Finger bones
(the only exception is the thumb) consist of three phalanges – closer to
the hand itself is located proximal, then the middle one, then the distal
or final. All phalanges are interconnected by unique interphalangeal
joints. There are only two phalanges on the thumbs – this is the proximal, and also
distal.All bases of the proximal phalanges will articulate with the heads
the metacarpal bones of the hand themselves, while they form the metacarpophalangeal joints.

Also on the skin
the palmar surface of each finger has a fairly large number of
sweat glands. There are no sebaceous glands and hair on this surface, and the subcutaneous itself
the fiber of the fingers will be separated using connective tissue jumpers,
which go from the skin directly to the periosteum of the phalanges. Much thinner
there will be skin that is on the back surface, and the area not only
the proximal but also the middle phalanx will be covered with hair.

Muscle tendons
attach directly to the bones of the phalanges – deep and superficial
flexors of the fingers. The thumb has its own muscles, namely the long
and short flexors. Common extensors exist for the nameless and middle
fingers, and separate for the little finger, index and thumb.

Most common
it is the traumatic dislocation of the fingers. This type of dislocation is from
itself a complete displacement of the articular ends of the finger bones themselves, which can
be the result of serious injury.Dislocation of the fingers of the hand will
accompanied by the formation of a rupture and an articular capsule, as well as ligaments. If
there was an incomplete displacement of the articular surfaces, this type of dislocation is
the name of incomplete dislocation or subluxation.

Almost all
cases of dislocation of the fingers of the hand occurs as a result of obtaining
sudden and rather strong muscle contraction, as well as after receiving
serious indirect injury.

Dislocated is considered
far or peripheral region of the limb.Also, doctors distinguish between fresh
dislocations, if no more than two days have passed since the injury,
stale, about three or four weeks after injury, old,
if more than four weeks have passed since the injury.

There are irreducible
dislocations, in the event that between the articular surfaces as a result of dislocation
turned out to be soft tissues located nearby, as well as habitual dislocations, that is
the type of injury that is constantly repeated, open and closed dislocations, if
damage has occurred or there is no damage to the skin.

Difficult
dislocations, which may be accompanied by fractures or severe nerve damage,
as well as blood vessels, and of course, subluxations and uncomplicated dislocations.

Extremely rare
there are dislocations of the fingers of the hand, but at the same time, the most common is
it is the dislocation of the thumb that occurs in the area of ​​the metacarpophalangeal
joint. Also today, the dislocation of the thumb outwards, to the palm, and
to the rear, of course.At the same time, displacement may occur
proximal phalanx directly to the back of the hand.

This type of dislocation
finger can occur as a result of a rather sharp and strong extension
the thumb while falling onto the hand. At this time there is
slipping of the proximal phalanx onto the dorsum of the first metacarpal
bones. In this case, its head enters directly into the gap.
capsules on the palmar surface.

This provision may
accompanied by the formation of characteristic springy fixations, that is, during
performing passive movements in the joint area, there is a slight springy
resistance (performed either with the other hand or by another person).

Proximal itself
the phalanx will be almost at right angles to the metacarpal
bones, and the distal phalanx bends at approximately the same angle. In that
case, it becomes possible not only to see, but also to probe the head first
metacarpal bone directly on the palmar surface.

Most often occurs
the formation of dislocation directly in the interphalangeal joints, as well as dislocations,
which form in the joint between the bone of the main phalanx and the metacarpal bone
finger.

Quite often
it is the dislocation of the first toe that occurs, while the reason that is capable of
excessive extension of the finger itself can provoke its formation,
much less often this type of dislocation occurs as a result of strong flexion
finger.This type of dislocation will be accompanied by the formation of a characteristic
deformities, and a rather strong and sharp pain appears in the area
damage and swelling. All movements in the area become completely impossible.
injured joint.

Direction of this view
dislocation occurs due to traction for the injured finger. Subject to infringement
adjacent soft tissue becomes impossible to reduce
dislocation by this method. In this case, there is a need to conduct
immediate operative reduction of dislocation.

Symptoms

Thumb dislocation may
occur as a result of receiving a direct blow directly to
fingertip, for example, it becomes possible while playing basketball
or volleyball.

In addition, dislocation of the finger joint, today,
is one of the most common occupational injuries
athletes. However, there are cases that this type of injury is possible as a result
falling directly onto the arm – the risk of injury increases significantly,
if a person falls with an open palm.

As a result of what happens accidentally
damage to the finger, during which a dislocation of the joint was formed, exists
the likelihood that the appearance of the
the affected organ, that is, the finger.

External signs of the formation of a dislocation of the finger will be
quite pronounced, making it easy enough
diagnose this type of injury. So, the main symptoms of a dislocated finger
the hand is that its external deformation occurs, because the bones that
are in its composition, will not take a natural position.

Before the victim is taken to
clinic and will receive qualified medical care before
examination, there is a possibility that not only a dislocation occurred,
but also a fracture or serious sprain.

Among the main signs of dislocation of a finger
the appearance of rather strong painful sensations, manifested in
areas of damage. In this case, the pain will increase significantly during
attempts to make even the slightest movement with the injured finger, and of course, during
time of touching the injury.There is also swelling of the finger and a pronounced
deformation in the area of ​​damage.

Diagnostics

In almost all cases, diagnose the presence of
dislocation of the finger of the hand becomes possible as a result of a thorough examination
victim. However, if subluxation is suspected,
additional clinical studies will be needed.

Always the ultimate research method is
X-ray examination, since thanks to the resulting image it will become
it is possible to establish not only the final, but also the most accurate diagnosis
to the victim.

Prevention

At the heart of the prevention of injury such as
dislocation of the finger of the hand, the observance of safety measures during classes lies
sports.

Treatment

Only after the final
the diagnosis and the type of dislocation was determined, which becomes possible due to the
X-ray, the doctor chooses the method of treatment. There is also a need to exclude
the likelihood of a fracture in the area of ​​damage, since in this case
more serious treatment will be needed.

Most often, the reduction of the dislocation is carried out using
using a closed method. This procedure is carried out under the influence
local anesthesia. Directly on the damaged phalanx of the finger will be
superimpose a special loop made of a ribbon (while the width
the ribbon is almost completely equal to the height of the damaged phalanx), after
which is the retraction of the phalanx directly along the healthy fingers.

In this case, simultaneous overextension is carried out
finger directly in the metacarpophalangeal joint, and the doctor also conducts
pressure on the head of the first metacarpal bone (the direction of pressure should
be in the back, that is, the opposite side).

After the articular surface itself
the proximal phalanx of the finger slides directly over the apex of the head
metacarpal bone, the doctor himself will have to bend the injured finger exactly in
metacarpophalangeal joint. Further on the damaged finger will be superimposed
special plaster cast – from the elbow to the middle
the thumbnail, as well as the metacarpophalangeal joint of the remaining fingers.

The plaster is removed after about three weeks, after which
the patient is assigned special therapeutic exercises, as well as massage, and
physiotherapy, of course.Within a month or a month and a half, after
the implementation of the reduction of the dislocation, there is a complete recovery
working capacity and you can return to your usual way of life.

It is worth remembering that it is strictly forbidden to conduct
self-reduction of dislocations, as unskilled actions can
as a result, lead to more serious complications.

Fracture Galeazzi | EMC

Fracture-dislocations of Galeazzi are injuries that combine a fracture of the distal third of the radius with dislocation of the head of the ulna in the distal radio-ulnar joint.Cooper (1842) and R. Galeazzi (1934) contributed to the study of these injuries.

Campbell in 1942 called them “fractures of necessity,” emphasizing the need for surgery to restore normal anatomical relationships.

Fracture-dislocations of Galeazzi account for up to 7% of fractures of the forearm bones, occur when falling on the hand in the pronation position with the transfer of force to the forearm. The components of the injury are ruptures of the square pronator of the forearm, brachioradialis muscle, and extensor tendons of the thumb.

Patients complain of pain in the middle and lower third of the forearm, limitation of movement in the wrist joint. Expressed swelling of soft tissues, subcutaneous hematoma. The superior head of the ulna is palpated under the skin. In severe cases, signs of forearm compartment syndrome (compression of arteries, veins, and nerves by damaged edematous soft tissues) may develop. Damage to the anterior interosseous nerve of the forearm, which innervates the long flexor of the thumb and the deep flexor of the fingers, is common.This leads to a violation of the mechanism of squeezing between the thumb and forefinger.

To clarify the diagnosis, it is necessary to perform an X-ray of the forearm in two projections with the capture of the wrist and elbow joints. In doubtful cases, as well as for planning surgery, radiography of an intact limb, computed tomography can be useful.

Fracture-dislocations of Galeazzi are an indication for surgical treatment – open reduction and osteosynthesis of the diaphysis of the radial bone with a plate and, in case of unstable injuries, fixation of the head of the ulna in the articular notch with a wire.In severe cases with fractured bone, bone grafting may be required. In the postoperative period, immobilization is required in the supination position.

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The fact that any innovation has both positive and negative sides is perhaps not worth arguing. The only question is which qualities will outweigh? The world-famous smartphone was no exception to this rule. Its detrimental effect on the eyes, the mental and physical state of a person as a whole is no longer in doubt.

Smartphone and health: an alarming trend

The number of smartphone users in the world is growing at a cosmic rate. According to the Statista Institute in Hamburg, there are about 57 million of them in Germany today. Two years ago, the Federal Office for Occupational Safety and Health (Bundesanstalt für Arbeitsschutz und Arbeitsmedizin) devoted a study to the effects of physical exertion to which active gadget users are exposed. After analyzing the results of more than 40 scientific studies conducted in the period from 2007 to 2015, experts came to the conclusion that when working with a tablet or smartphone for a long time (for personal purposes or within the framework of professional activity), the spine is especially affected (due to improper tilt of the head) and the thumb of the dominant hand.

Recently, orthopedic surgeons have been paying attention to the growing number of not only elderly, but also young patients with signs of inflammation of the muscles and tendons of the hands. Doctors more and more often register drawing pains in the hand in those who hold a mobile device in one hand for a long time, typing with their thumb or playing a computer game.

New Era Disease

Smartphone Finger Syndrome affects mainly people between 15 and 25 years old

A relatively new orthopedic disease in Germany has already been called Handy-Daumen, and WhatsApp Syndrome in English-speaking countries.Scientifically, inflammation of the tendon that coordinates the mobility of the thumb is called de Quervain’s tendovaginitis. In more detail, in medical terms, – tendovaginitis of the long abductor and short extensor muscles of the thumb of the hand in the place of their passage through the osteo-fibrous canal at the level of the styloid process.

If nothing is done, the disease becomes chronic, and the pain spreads up the arm, up to the shoulder and spine, warns occupational therapist at the University Hospital in Leipzig, Norina Weisenbilder.

In the current press release of the clinic, specialists draw attention to the fact that the natural purpose of the thumb, which performs an auxiliary function in the course of evolution, is to help the hand to gather the fingers into a fist in order to grab something, hold something. The movement that requires stretching, protruding the thumb for typing on the keyboard or touch screen of the gadget is not provided by human anatomy.

Until now, this disease has affected musicians, athletes, hairdressers and representatives of other professions who have had to perform the same type of hand movements for a long time.And, most often, elderly people. Today, notes the Leipzig-based orthopedic surgeon Stefan Langer, with such typical problems, the university hospital is mainly visited by patients aged 15-25 years. But not everything is so hopeless, doctors say.

How to treat a smartphone finger

It is better to type on a smartphone with fingers of both hands

Methods of treatment for young patients are radically different from those that are usually used in cases with the elderly.Stefan Langer advises not to rush to prescribe strong medications (for example, cortisone injections). And even more so he is against hasty surgery. For smartphone owners, an experienced surgeon recommends putting the electronic device aside for at least a week. Exactly so much is needed to subside the pain.

In addition, it is advisable to undergo a course of physiotherapy, which helps to achieve elasticity of the fascia and tendons and thereby relieve pain. Kinesio tape and special bandages that fix the thumb in the correct position have proven themselves well.Text on a tablet or phone German orthopedists advises to type with the fingers of both hands at the same time to avoid one-sided loading of the dominant thumb. “That way, your finger doesn’t have to stretch across the entire touchscreen keyboard,” explains Norina Weisenbilder. The signature “Merkel rhombus” (in the main picture), a gesture in which the German Chancellor joins his hands in front of his stomach, extending his thumbs and forefingers, also helps. But the main thing is that you should reconsider your attitude towards a smartphone and, in general, limit the time of using mobile devices, finding your own golden mean.

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