Dislocations can occur at any finger joint, but the most commonly affected joint is the middle knuckle, the PIP joint. Finger dislocations occur when a joint is forced beyond its normal limits of movement. This causes the internal stabilizing structures i.e. the ligaments, to be stretched or torn.
The direction that the finger is forced into determines which structures will be injured. If the finger is bent backwards (hyper-extended), it is highly likely that the volar plate, a thick ligament that lies on the front of the joint has been injured. If the finger is bent sideways, the collateral ligaments which provide sideways stability will have been injured. If a PIP joint is dislocated downwards, towards the palm, the tendon on the back of the joint is likely to have ruptured. This is a significant injury, which requires careful management by a hand therapist to prevent long term problems with the finger.
What to do if you dislocate your finger
If you see your finger dislocate on the sports field, it is best not to try and relocate it yourself, as there may also be a broken bone (fracture) and relocating it yourself may make the fracture worse. Following a finger dislocation, we recommend attending a hospital where an x-ray can be performed and a health professional can safely relocate the joint. After the joint has been put back into place it is important to get the right treatment. Treatment will depend on the direction in which the joint dislocated.
Treatment of Finger Dislocation
Hand therapy following finger dislocation is likely to include the following:
SPLINTING: Your hand therapist may fabricate a custom-made thermoplastic splint to protect the injured structures during the healing process.
EXERCISES: Except in the case of volar dislocation where a tendon is ruptured, early movement of the injured finger is recommended to prevent long term joint stiffness.
SWELLING MANAGEMENT: It is important to reduce the swelling as quickly as possible. As well as elevating the hand, and applying ice in the early stages, a hand therapist will help to reduce the swelling by applying a compressive wrap to the finger, or fitting a custom-made fingerstall.
BUDDY STRAPPING OR BUDDY STALLS: You may be fitted with buddy straps, or custom-made buddy stalls which hold the injured finger next to the neighbouring finger to protect against sideways forces, yet still allow movement of the injured finger.
So, whether you're recovering from an injury, surgery, or experiencing limitations due to a chronic condition, a hand therapist can help you return to doing the things you love in the quickest possible time.
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