Point Taken: Finger Dislocations

Finger dislocations are relatively simple to identify and treat, but ligament and volar plate ruptures are often missed. Radiographs are not always indicated, but are useful in locating the area of injury and noting avulsion fractures. It is important to listen to the patient’s story to identify the mechanism by which the injury occurred because mimicking this mechanism is typically the best way to relocate the joint. Patients typically do not always need local anesthesia or digital block because relocation techniques are quick and can often be done while simply distracting the patient for a second or two. Treatment is dependent on your skill level, comfort, and ability to recognize these injuries.   DIP, PIP, or MCP dislocation can be caused by any kind of significant force to the area such as hyperextenion or flexion, trauma, pressure, or crush injuries. Keep in mind that primarily the IP joints are much more secure than the MCP joints because of the IP joints’ bicondylar arrangement and the fact that the collateral ligaments are tight throughout the entire range of motion. (Medscape, 2014.) Dislocation of any phalanx joint dorsally can cause separation from the volar plate while lateral dislocations can disrupt one or both of the collateral ligaments. Tendon injury and avulsion fractures may also occur.  Figure A. Dorsal dislocation of second phalynx. (Lippincott, Williams & Wilkins, 2001.)  Figure B. Volar dislocation of second phalanx. (Lippincott, Williams &a...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs