Dislocations of small joints of the fingers or thumb are usually the result of a forceful external blow against the small
joints. Those engaging in contact ball sports or manual workers are more at risk of
dislocations. It is important to have immediate treatment in A&E for a suspected dislocation and to have an x-ray to confirm
the diagnosis and to check for possible fractures.
Usually a procedure to
re-position the bones is performed, called a closed reduction. This should not
be attempted at home or by a non-skilled person as it is easy to damage connective tissue around the joint
causing long term damage and an increased risk of repeated dislocation.
If a closed
reduction is not successful and the joint continues to be unstable or to dislocate, surgery may be required.
Trauma to the connective tissues, such as synovial membrane,
collateral ligaments and the volar plate incurred during the dislocation, cause the most pain and can swell considerably. If not managed correctly they can be damaged during the procedure to realign the joint and this can cause repeated dislocation in the future.
The first action to take with a suspected dislocation is to remove rings and apply a cold or ice compress to reduce swelling. Keeping the arm elevated after the injury and after reduction will help to limit swelling.
Prolonged swelling causes complications such as stretched ligaments, excessive bruising and stiff joints that can have difficulty moving even after the swelling has reduced.
Patients also describe
numbness or
pins and needles caused by bruising to the digital nerves. This usually returns to normal sensation when the swelling has reduced.
Initially the person will be fitted with a “one size fits
all” splint in A&E to immobilise the affected joint for several days. If you are not happy with your splint and would like something more comfortable that is custom made, Hand Kinetics can help you.
Once the initial swelling has been treated with gentle compression and/or ice therapy by your Hand therapist, and your finger has been rested in a splint for a few days, it is very important to begin very gentle exercises under the
guidance of your Hand therapist. Most people will heal well if Hand therapy and
splinting are appropriately managed from the outset.
Depending on which joint dislocated, an analysis of your daily activities may be necessary to determine any risk factors until fully healed.
Please note:
If you have had arm or hand surgery please telephone to discuss this before attending. It is always helpful to bring any reports you may have if you recently attended hospital for your hand or arm condition.
At Hand Kinetics our Hand therapists will make you a personalised finger or thumb splint to keep the correct alignment of connective tissues while they heal.
The same splint can be adjusted over the next 3-5 weeks as swelling reduces, depending on the injury, and as range of movement improves .
In some cases, healing can be accelerated by targeted therapeutic ultrasound to the affected connective tissue or thermal heat therapy to ease stiffness in the joint while continuing to wear a support at other times.
Once the splint is removed and you return to gentle activity, a strengthening programme designed by Hand Kinetics will ensure optimum stability is achieved and you can return to your usual activities at work or sporting activities.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
