The human hand has an extremely delicate structure. A complicated interaction of tendons, muscles and joints ensures its mobility. A finger dislocation, medically: finger luxation, is painful and leads to undesirable movement restrictions.
What is a finger dislocation?
Finger dislocation or finger luxation refers to an injury to one or more finger joints. In this case, there is a displacement of the joint surfaces in opposite directions. The unnatural position of the finger joint and finger can also be seen externally. If the joint surfaces have not completely shifted against each other, the finger dislocation is called a subluxation or incomplete finger dislocation. While the thumb has only two phalanges, each with a connecting joint, the remaining four fingers each have three phalanges. Between them are the base joint, the middle joint, and the terminal joint of each finger. Finger dislocation can generally occur at all joints of the fingers.
Causes
Finger dislocations are caused by force applied to the corresponding finger joint. Overextension of the finger or a combination of overextension with simultaneous compression of the joint triggers finger dislocation. It is therefore very common in sports. People who play ball sports such as volleyball and basketball, but also handball, are particularly at risk. Receiving the ball with outstretched fingers leads to injury of the joint due to the force of the ball. The finger dislocation often brings further injuries to the joint. Thus, tears in the joint capsule and/or ligaments, as well as joint fractures, may occur as a result.
Symptoms, complaints, and signs
In the case of a finger dislocation, the affected person primarily suffers from very severe pain. This occurs in the finger and can also spread to the neighboring areas, so that there may also be severe pain in the entire hand or even arm. Due to the permanent pain, patients suffer from restricted mobility and therefore limitations in everyday life. Likewise, the affected person may no longer be able to perform his or her activities due to the finger dislocation. Swelling or disturbances in sensitivity and even paralysis also occur. In some cases, patients suffer from pain at night due to finger dislocation. These often lead to sleep problems and thus irritability and various psychological complaints or depression. Finger dislocation can also be associated with a torn ligament, which honestly reduces the stability of the fingers. In this case, a minor surgical intervention is usually necessary. In case of early treatment of finger dislocation, no particular complications occur and there is a positive course of the disease. If treatment of finger dislocation does not occur, inflammation may occur, which can permanently damage the finger. The patient’s life expectancy is not negatively affected by the disease.
Diagnosis and course
Finger dislocation is an extremely painful injury and leads the patient to the doctor for this reason alone. There is immediately a massive restriction of movement as a result of the malposition, as well as swelling of the affected finger. If, in addition to the joint, nerves are also damaged, the disturbance of sensation can result in an unpleasant tingling sensation. The finger dislocation is immediately recognizable as such from the outside due to the malposition of the finger. Therefore, two X-rays are taken to rule out additional fractures and to confirm the diagnosis. A torn ligament can be detected by the physician by examining the lateral stability of the finger. However, further injuries to the joint capsule as well as to the tendons and ligaments can only be reliably ruled out in finger dislocation by an MRI (magnetic resonance imaging).
Complications
Finger dislocation can cause a number of complications. Initially, the overstretch causes pain in the fingers and limited movement. As the finger dislocation progresses, the fingers may swell and cause circulatory problems and loss of sensation. If nerves are damaged in addition to the joint, an unpleasant tingling sensation may occur, which usually persists until the injured hand is treated surgically.If a torn ligament is also present, this can lead to avoidance postures and subsequently to a malposition of the affected fingers. In the case of a harmless dislocation, serious complications are rare. However, allergic reactions to prescribed medications may occur during treatment. With surgery, there is some risk of further nerve and muscle injury. Often
there is also permanent immobility of the finger joints. Ten to fifteen degrees of loss of motion is common, depending on the type and severity of the dislocation. The restricted freedom of movement increases the risk of accidents in everyday life and can also have a negative effect on the psychological condition in the long term. In general, however, severe complications occur extremely rarely as a result of finger dislocation.
When should you go to the doctor?
A finger dislocation is already a reason to see a doctor because of the clearly noticeable pain. In addition, a dislocated finger is easily visible because of the clear crooked position. It also makes sense to see a doctor because a finger dislocation can lead to a number of complications. For example, damage to ligaments, tendons and nerves can occur, which can lead to loss of function of the finger if irritation from the damage persists. Most finger dislocations are considered harmless and are straightened by an appropriately trained primary care physician or a specialist. This is sometimes painful and necessitates anesthesia. A subsequent splinting ensures a good healing. In addition, the corresponding area must be x-rayed to determine or rule out any accompanying damage (joint capsule tears, finger fractures, etc.). More complicated dislocations, in which surrounding tissue or the joint itself has also been affected, may require surgical intervention. Clarifying the severity of the dislocation is therefore the top priority. Otherwise, permanent damage associated with pain is possible. In case of doubt, admission to a hospital may be the goal. Here, in order to clarify appropriate treatment, the extent of the damage is determined and often first aid is given to stop pain. Amateurish re-setting of the finger by the affected person himself or a third party should be refrained from.
Treatment and therapy
Immediately after the onset of finger dislocation, the affected finger should not be moved and should be held upward, if possible, to minimize swelling. It is recommended that rings be removed immediately and that the finger be cooled as much as possible. After ruling out fractures and injuries to nerves, tendons or ligaments, the doctor will attempt to reset the finger joint. This procedure is painful and is therefore usually performed under local anesthesia. An X-ray is then taken to check the joint. The injury around the capsule-ligament apparatus must now heal and is provided with a tape bandage or splint and thus immobilized. The healing process of a finger dislocation can take two to six weeks. If the attempt to set the finger joint does not bring the desired success or if a joint fracture has occurred, surgery of the finger dislocation is usually unavoidable. This also applies if injuries to the joint capsule have occurred or if a torn ligament is present. In the case of a simple finger dislocation, there is no longer any restriction of movement after the injury has healed. However, if it is a more complicated finger joint injury, mobility may be limited for a longer period of time. However, targeted finger exercises, learned under the guidance of an occupational therapist if necessary, can quickly improve mobility after a finger dislocation.
Outlook and prognosis
People with a finger dislocation have a good prognosis. From a medical perspective, the existing sprain is a harmless injury. Within a few weeks or months, the injured region is usually healed. Freedom from symptoms and complete fist closure can be expected after about three months. For an optimal healing process, the affected person should take it easy on the injured hand and allow it sufficient rest. Exertion of the hands and fingers should be avoided. Sporting activities and in particular ball sports such as basketball or volleyball should also be avoided during the regeneration phase.In everyday life, processes such as brushing teeth, writing or all gripping processes should temporarily be performed by the healthy hand. As soon as the affected person notices an increase in discomfort, a break should be taken and the injured hand should be given more rest. If the doctor’s instructions are followed, there is a rapid improvement and regression of the impairments. Targeted training sessions and training adapted to the circumstances help to build up the muscles in the hands. At the same time, overloading should be avoided. Once the healing process is complete, the fingers and hands can gradually regain their full load-bearing capacity. In the case of a finger dislocation, neither secondary symptoms nor long-term impairments are to be expected if the healing process is optimal.
Prevention
The risk of finger dislocation in sports can be significantly reduced by taping the fingers that are most at risk. Furthermore, it is important to reduce the force of the ball on the joints by bending the fingers slightly. Strong hand and finger muscles support the joints, but can only slightly minimize the occurrence of finger dislocation, especially in sports.
Aftercare
A finger dislocation usually does not require any special aftercare. However, such a dislocation can occur in varying degrees of severity, so follow-up care does need to occur under certain circumstances. As a rule, such a dislocation is caused by sudden or unusual overloading of the fingers, resulting in overstretching of the muscles. Immobilization of the entire hand is necessary to bring about a quick and complete recovery. However, if there is no significant improvement after a few days, a doctor should be consulted immediately. A splint can be used to effectively counteract finger dislocation. Subsequent visits to the doctor are essential in such a case and should be strictly adhered to. Otherwise, considerable complications may arise, which in the worst case may even require surgical treatment. The consequence: permanent and chronic pain, which can lead to impairment of the entire hand. A dislocation of the fingers should also be examined and observed by a doctor afterwards. In this way, any complications can be detected early enough and treated accordingly. Those who take advantage of these follow-up examinations can expect a quick and smooth recovery. The finger should be able to bear full weight again after three to four weeks.
What you can do yourself
If the finger is dislocated, it is important to immediately take care of the fingers and the hand at the same time. Stress from lifting, grasping or carrying objects should be completely avoided. Sports activities or activities such as writing should also be limited. The fingers are to be cooled sufficiently with cold water, caring ointments or home remedies such as wraps with arnica or aloe vera. If possible, the affected region should be kept still. The less movement of the arm and hands, the better is a quick healing possibility and a spreading of the complaints is avoided. Since a dislocation often causes swelling of the fingers or parts of the hand, only a loose bandage or no bandage at all should be used without consulting a doctor. This will prevent a feeling of tightness in the injured region. The fingers should be checked for malpositioning of the bones or open wounds. If the dislocation has caused damage to the bones or joints in the fingers, a doctor must be consulted. There is too great a risk of permanent damage occurring. In the case of open wounds, clean them carefully and keep them sterile so that no germs or pests can enter the organism.
