Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Dislocation of Finger Joint

SYMPTOMS

There is intense localised pain and deformation (bayonet position, where distal phalanx is retracted over the dislocated joint by
flexor tendons) of a meta-carpo-phalangeal (MCP), proximal inter-phalangeal joint (PIP) or distal inter-phalangeal (DIP) joint after direct trauma from a hard ball or a fall on a stretched-out finger.

AETIOLOGY

One or more joints may dislocate and the joint capsule ruptures, causing bleeding and other soft tissue injuries.

CLINICAL FINDINGS

There is tenderness on palpation and swelling over the deformed joint.

INVESTIGATIONS

X-ray should be taken, to exclude fractures.

TREATMENT

Repositioning of the joint can usually be done on the field by traction of the distal phalanx while holding the hand firmly.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon and hand specialist if there are multiple joint dislocations, if the joint pops back to a dislocated position or if this manoeuvre is very painful. Suspected fracture or complicated soft tissue injuries may require specialist treatment.

EXERCISE PRESCRIPTION

Most sports can be maintained immediately after repositioning by strapping the adjacent fingers for support. After repositioning, the symptoms are usually relieved almost immediately and most activities can be back to normal within six weeks. Running, cycling and water exercises (when the wound is healed after surgery) are good alternatives to keep up general fitness. Gym training can be maintained.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs.

DIFFERENTIAL DIAGNOSES

This is a clinical diagnosis but fractures and dorsal plate ruptures, which prevent repositioning, can complicate the outcome.

PROGNOSIS

Excellent, if treated appropriately.

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