MANUAL MINORS
Finger phalangeal dislocations occur when the bones forming the finger joints move out of their normal position. They are typically caused by direct trauma, a fall onto the fingers, or forced movements beyond the joint’s normal range. These dislocations most commonly affect the proximal (PIP) and distal (DIP) interphalangeal joints.
Diagnosis
Diagnosis is made through clinical evaluation, revealing visible deformity, intense pain, swelling, and limited movement in the affected finger. X-rays confirm the dislocation and rule out associated fractures.
Differential Diagnosis
Condition | Key Differences |
|---|---|
Phalangeal fracture | Fracture line visible on X-ray, with more severe localised pain at the fracture site. |
Interphalangeal sprain | Swelling and pain, without visible bone displacement on imaging. |
Tendon rupture | Difficulty extending or flexing the finger without bone deformity. |
Post-traumatic arthritis | Chronic pain, stiffness, without recent trauma, with degenerative changes on X-rays. |
Emergency Management
Immobilise the affected finger in its deformed position until reduction can be performed.
Apply ice to reduce swelling and administer analgesics or anti-inflammatories for pain relief.
Perform a closed reduction of the dislocation under local anaesthesia or sedation, using precise techniques to restore the joint to its original position.
Confirm reduction with post-reduction X-rays.
Stabilise the joint with a splint or “buddy taping” (taping the injured finger to the adjacent one) during recovery.
Definitive Treatment
After successful reduction, the affected finger may require immobilisation with a splint for 1-3 weeks, depending on the severity. Rehabilitation with mobility exercises is crucial to prevent joint stiffness and restore full function. If ligament injuries or persistent instability are present, surgical treatment may be required.
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