MANUAL MINORS
Hand dislocations are joint injuries in which the bones that form the hand’s joints are displaced from their normal position. These injuries typically occur after direct or indirect trauma, such as falls on an outstretched hand or sports accidents. The most common dislocations occur in the fingers (interphalangeal) and at the metacarpophalangeal joint.
Diagnosis
Diagnosis is based on the trauma history, presenting with symptoms such as intense pain, visible deformity, inability to move the hand or fingers, and swelling. X-rays confirm the dislocation by showing the abnormal position of the bones and ruling out associated fractures.
Differential Diagnosis
Condition | Key Differences |
|---|---|
Hand bone fracture | Fracture line visible on X-ray, with restricted mobility due to localised pain. |
Ligament sprain | Pain, swelling, and possible instability without bone displacement on X-ray. |
Tendon rupture | Difficulty extending or flexing the finger, without bone displacement evidence. |
Acute arthritis | Pain, stiffness, swelling without trauma, and chronic joint erosion on imaging. |
Emergency Management
Immediate immobilisation of the hand in the position of deformity, avoiding forceful manipulation.
Administration of analgesics and anti-inflammatory medications for pain control.
Closed reduction under local anaesthesia or sedation, using careful techniques to avoid further damage to joint structures.
Post-reduction X-rays to confirm proper alignment of the joint.
Application of a splint or immobiliser to protect the reduced joint.
Definitive Treatment
Depending on the severity, definitive treatment includes immobilisation for 2-4 weeks and physical therapy to regain mobility. In cases of instability or ligament damage, surgical intervention may be required to repair damaged tissues and ensure joint stability.
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