Hand > Finger Dislocation > Treatments

   Closed Reduction, Immobilization, Controlled Motion

Treatment Introduction

Based on the position of your finger dislocation, your physician will inject a local anesthetic directly into your finger or hand to aid in performing a closed reduction. Once this has been done, the dislocation will be reduced, or placed back in its normal position, by putting gentle pressure on the joint and moving the parts together. After a closed reduction has been performed the doctor will check the stability by moving the finger back and forth and with another X-ray. The stability of the joint will determine what type of splint is necessary and the length of time it needs to be worn. Some dislocations are unstable which means that the joint may redislocate every time you try and move the finger. These unstable dislocations are usually associated with breaks in the bone. They may require surgery to repair the torn ligament and associated broken bones.

Most splints are made of a combination of plastic and rubber, though some feature aluminum strips that keep the finger in a locked position when the splint is taped securely to the finger. The splint usually is covered with padding so that the aluminum is not exposed. Depending on the nature of your injury, your physician may prescribe a splint that is attached to a short arm cast that covers your hand and wrist.

After closed reduction of a finger dislocation, the length of time that you will need to keep the splint on varies according to the severity of your injury and which finger joint is affected. In some cases, the splint is adjusted at weekly intervals to reduce the degree of flexion so that the finger can be fully extended after three to six weeks. Follow-up will depend on how stable the dislocated joint is after reduction. If the joint is stable and not likely to re-dislocated the doctor may ask you to return in a week or two, if it is unstable he may want to see you back the next day. If you notice a recurrence of the deformity or a major change in range of motion or pain in the finger you should contact you doctor immediately, as this may mean that the joint has re-dislocated. The longer a joint is dislocated, the more swelling occurs, which makes it more difficult for the doctor to put the joint back into place and thereby increases your recovery time. You should return to the doctor approximately 8-10 days after the reduction to check the finger. During this time you can not get the area wet. When taking a shower you can place a large plastic bag on your arm with a rubber band at the top part of your arm. Hold your elbow over your head so that water does not role down your shoulder and into the bag. Commercially-made bags, which function in a similar way, can be purchased at a surgical supply store. Applying ice to the finger is helpful for the first two to three days. The cold causes the blood vessels to constrict (shrink). This reduces blood flow to the hand and therefore helps the body stop the internal bleeding which occurs from the torn ligament. This bleeding is seen through the skin which you call a bruise. Less bleeding means less inflammation, which means a quicker recovery and return to activities. Keeping the hand elevated also helps because it reduces blood flow to the hand and limits swelling. Swelling in the hand causes the pressure in the tissue to increase. Your brain interprets this pressure as pain; therefore, the more swollen the hand becomes, the more painful. By elevating the hand the fluid which has collected there runs down into the forearm just like a river runs down hills. This reduces the swelling of the hand and gets rid of the annoying throbbing that occurs after finger injuries.

Following closed reduction and splinting of a finger dislocation, your physician will usually suggest that you begin a program range of motion exercises as soon as possible. These can be performed or without the splint depending on your physician instructions, and should be continued even if slight swelling and stiffness occurs during the first few weeks. In some cases where the finger joint remains painful, a steroid injection may be required. The splint usually remains on for one to six weeks, depending on your specific injury. After the splint is removed, your physician may recommend buddy taping, in which the injured finger is taped to an adjacent finger. Depending on the severity of your injury, return of full joint motion can take as long as several months. During this time swelling and stiffness may recur. In many cases, however, athletes who have suffered finger dislocations have been able to return to their sports within a few weeks while the finger is still in the splint or is buddy-taped. This should only be done after consultation with your physician.

Though finger dislocations are contact injuries that often cannot be avoided, you can take steps to minimize your risk of suffering a dislocation. If you play contact sports like football, hockey, or lacrosse, make sure you wear padding that protects your hands and fingers. Never use old, worn-out pads that have lost their stiffness. Maintaining hand and finger strength and coordination also can help prevent some finger injuries. Ask your physical therapist for a specific program of exercises.