DISLOCATIONS OF FINGERS
WHAT ARE FINGER DISLOCATIONS ?
Dislocation means slipping of the joint from its normal position. A finger has three joints ; MCP joint, PIP joint and DIP joint.
Finger dislocations can occur at three levelsMCP joint ( Known as Kaplan’s dislocations )PIP jointDIP joint
DIAGNOSIS
Your doctor may ask for a plain X ray to confirm the diagnosis. Rarely CT may be required to obtain detailed information especially in fracture dislocations.
TREATMENT
PIP and DIP joint dislocations
Most of such injuries are managed successfully without surgery. They often are reduced in the outpatient clinic under local anaesthesia and splinted.
MCP dislocations
They may be simple or complex. Simple dislocations are managed in the outpatient clinic by bringing the joint to its normal position after giving local anaesthetic . Complex dislocations are often irreducible. Trial of reduction with local anaesthetic is attempted in an outpatient clinic. If successfully reduced , the finger is immobilised using a splint. If the trial is not successful , surgery will be required to bring the joint back to its normal position.
PIP fracture dislocations
They are common injuries. They may be stable or unstable. Stable ones are reduced under local anaesthetic in the outpatient clinic and splint is applied. Unstable ones need surgery.
Surgeries performed are:
Extension block pinning
Dynamic skeletal traction Eg. Suzuki frame, Zimmer splint etc
Open reduction and screw/ plate fixation
Volar plate arthroplasty
Hemihamate arthroplasty