Finger dislocation

What is it?

A finger dislocation is a joint injury in which the finger bones move apart or sideways so the ends of the bones are no longer aligned normally. Finger dislocations usually happen when the finger is bent backward beyond its normal limit of motion.

The bones that make up the joints of  the fingers are known by the medical terms phalanges and metacarpal bones. Any of these joints can be dislocated in an injury:

• Distal interphalangeal joints are in the finger joints closest to the fingernails. Most dislocations in these joints are caused by trauma, and there is often an open wound in the location of the dislocation.
• Proximal interphalangeal joints are the middle joints of the fingers. A dislocation in one of these joints is also known as a jammed finger or coach's finger. It is the most frequent hand injury in athletes, and it is especially common among those who play ball-handling sports, such as football, basketball and water polo. In most cases, the dislocation happens because the fingers are bent backward when an athlete tries to catch a ball or block a shot. Proximal interphalangeal joint dislocations also can happen when an athlete's fingers are twisted or bent by an opponent, especially when two athletes wrestle or grab for control of a ball.
• Metacarpophalangeal joints are in the knuckles, located where the fingers meet the rest of the hand. These joints connect the metacarpal bones in the palm with the first row of phalanges in the finger. Because these joints are very stable, metacarpophalangeal joint dislocations are less common than the other two types. When metacarpophalangeal dislocations do occur, they are usually dislocations of either the index finger or little finger (pinky).

Symptoms

A dislocated finger is crooked, painful and swollen, and its surface skin may be cut, scraped or bruised. If a dislocated finger has been straightened on the playing field, it may feel abnormally loose, weak or unstable afterward.

Diagnosis

Your doctor will suspect that your finger is dislocated if it appears deformed after an injury. In some cases, your doctor may order an X-ray of the finger to look for a fracture. When a finger bone is pulled away from connected tendons, it is common for a fragment of bone to separate from the main bone and stay with the tendon, a condition known as an avulsion fracture. Such fractures commonly accompany finger dislocations.

Expected duration

You can return to your sport once your dislocated finger has been realigned, your doctor has confirmed that the injured joint is stable and no bone is fractured, and your finger tenderness and swelling have improved. For a few weeks, you will need to wear a padded finger splint or buddy tape, which is used to strap the injured finger to an uninjured finger nearby for support.

If you need surgery to repair your dislocated finger, it usually takes at least four to six weeks before you can return to your sport.

Prevention

After your dislocated finger has been treated, you often can prevent it from being injured again by using a protective splint or taping it to another finger. If repeated dislocations occur, surgery may be recommended.

Treatment

A dislocated finger can be corrected with or without injecting local anesthesia. To correct the dislocation, the doctor will press against the displaced bone to dislodge the bone if it is caught against the side of the joint. As the end of the bone is freed, the doctor can pull outward to restore the bone to its correct position. This is called closed reduction. Once your finger joint is back in its normal position, you will wear a splint or tape the finger to another finger for three to six weeks, depending on the specific type of your dislocation.

If your doctor cannot straighten your finger using closed reduction or if your injured joint is not stable after closed reduction, your dislocated finger may need to be repaired surgically. Surgery is also used to treat finger dislocations that are complicated by large fractures or fractures that involves the joint.

When to call a professional

Call your doctor immediately if you injure your finger and your finger is crooked, deformed, painful or swollen. If you are an athlete and someone straightens your injured finger on the playing field, check with your doctor to make sure that the injured joint is stable and not fractured. A dislocated joint that has an open wound should not be moved. It should be carefully splinted and evaluated immediately by a physician.

Prognosis

The long-term outlook is usually good, although it may take four to six months for your finger pain to disappear. In some cases, there is also a small amount of permanent swelling around the injured joint, especially an injured proximal interphalangeal joint. In athletes, a finger that has been dislocated often is injured again.

Additional info

National Institute of Arthritis and Musculoskeletal and Skin Diseases
https://www.niams.nih.gov/

National Rehabilitation Information Center (NARIC)
https://www.naric.com/

National Athletic Trainers' Association
https://www.nata.org/