Finger Dislocation

 

What Is It?

When a dislocation occurs in a finger joint, the finger bones move apart or sideways so the ends of the bones are no longer aligned normally. Finger dislocations usually happen when the finger has been bent backward beyond its normal limit of motion. In the most typical finger dislocation, the bone farthest from the wrist is forced out of the joint in the direction of the knuckle.

The bones in the fingers are known by the medical terms phalanges and metacarpal bones. Every knuckle in the hands and fingers contains a joint between two of these bones, and any of these joints can be dislocated in an injury:

  • Distal interphalangeal joints are in the finger knuckles closest to the fingernails. Most dislocations in these joints are caused by trauma, and there is often an open wound in the location of the dislocation.


  • Proximal interphalangeal joints are the middle joints of the fingers. A dislocation of this joint is also known as a jammed finger or coach’s finger. It is the most frequent hand injury in athletes, and is especially common among those who play ball-handling sports, such as football, basketball and water polo. In most cases, the dislocation happens because the fingers are bent backward when an athlete tries to catch a ball or block a shot. Proximal interphalangeal joint dislocations also can happen when an athlete’s fingers are twisted or bent by an opponent, especially when two athletes wrestle or grab for control of a ball.


  • Metacarpophalangeal joints are joints within the knuckles of the hand, where the bulk of the hand joins to the fingers. These joints connect the metacarpal bones in the palm and the first row of phalanges in the finger. Because these joints are very stable, metacarpophalangeal joint dislocations are less common than the other two types. When metacarpophalangeal dislocations do occur, they are usually dislocations of either the index finger or little finger (pinky).

Overall, finger dislocations and other soft-tissue finger injuries account for more than 82 percent of all traumatic injuries to the hand. In athletes, treatment of a finger dislocation often begins on the playing field, when the athlete straightens the crooked finger or allows a coach or trainer to do it.

Symptoms

A dislocated finger is crooked, painful and swollen, and its surface skin may be cut, scraped or bruised. If a dislocated finger has been straightened on the playing field, it may feel abnormally loose, weak or unstable afterwards.

Diagnosis

Your doctor will suspect that your finger is dislocated if it appears deformed. In some cases, your doctor may order an X-ray of the finger to look for fractures. When a finger bone is pulled away from connected tendons, it is common for a fragment of bone to separate from the main bone and stay with the tendon, a condition known as an avulsion fracture. Your doctor will check the feeling and movement of your finger to check whether any nerves or tendons have been damaged.

Expected Duration

You can return to your sport once your dislocated finger has been realigned, your doctor has confirmed that the injured joint is stable and no bone is fractured, and your finger tenderness and swelling have improved. For a few weeks, you will need to wear a padded finger splint or buddy tape, which means strapping the injured finger to an uninjured “buddy” finger nearby for support.

If you need surgery to repair your dislocated finger, it usually takes at least four to six weeks before you can return to your sport.

Prevention

After your dislocated finger has been treated, you often can prevent it from being injured again by using a protective splint, buddy tape or, in some cases, a playing cast.

Treatment

Correcting a dislocated finger can be done with or without injected local anesthesia. To correct the dislocation, the doctor will press against the displaced bone to dislodge the bone if it is caught against the side of the joint. As the end of the bone is freed, the doctor can pull outward to restore the bone to its correct position. This is called closed reduction. Once your finger joint is back in its normal position, you will wear a splint or buddy tape for three to six weeks, depending on the specific type and location of your dislocation.

If your doctor cannot straighten your finger using closed reduction, or if your injured joint is not stable after closed reduction, your dislocated finger may need to be repaired surgically. Surgery also is used to treat finger dislocations that are complicated by large fractures or a fracture that involves the joint.

When To Call A Professional

Call your doctor immediately if you injure your finger and your finger is crooked, deformed, painful or swollen. If you are an athlete, and someone straightens your injured finger on the playing field, check with your doctor to make sure that the injured joint is not unstable or fractured. An open wound over a joint with a dislocation should not be moved. It should be carefully splinted, and be evaluated immediately by a physician.

Prognosis

The long-term prognosis is usually good, although it may take four to six months for your finger pain to disappear. In some cases, there is also a small amount of permanent swelling around the injured joint, especially an injured proximal interphalangeal joint. In athletes, a finger that has been dislocated often is injured again.

Johns Hopkins patient information

Last revised:

Diseases and Conditions Center

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.