Dislocated Wrist: Finger Movement, Symptoms, and Emergency Care

Can You Move Your Fingers with a Dislocated Wrist?

While a dislocated wrist primarily affects the bones of the wrist joint, it is often still possible to move your fingers to some extent, though this movement will likely be severely painful, limited, and potentially compromised due to associated swelling, nerve irritation, or tendon impingement. Immediate medical attention is crucial.

Understanding the Wrist and Hand Anatomy

To comprehend the impact of a wrist dislocation, it's essential to understand the intricate anatomy of the wrist and hand. The wrist joint (radiocarpal joint) is formed by the distal ends of the radius and ulna (forearm bones) articulating with the eight carpal bones. These carpal bones are arranged in two rows: the proximal row (scaphoid, lunate, triquetrum, pisiform) and the distal row (trapezium, trapezoid, capitate, hamate).

Crucially, the muscles responsible for finger movement (flexion, extension, abduction, adduction) are primarily located in the forearm. These "extrinsic" muscles send long tendons that cross the wrist joint, passing through specific tunnels (e.g., the carpal tunnel for flexor tendons) before attaching to the bones of the fingers. The "intrinsic" muscles, located within the hand itself, also contribute to fine motor control of the fingers.

What is a Wrist Dislocation?

A wrist dislocation occurs when one or more of the carpal bones are displaced from their normal anatomical alignment, particularly in relation to the radius and ulna, or from each other. Common types include perilunate dislocations (where the carpal bones dislocate around the lunate bone) and lunate dislocations (where the lunate itself is displaced). These injuries are typically the result of high-energy trauma, such as a fall onto an outstretched hand (FOOSH injury).

Symptoms of a wrist dislocation include:

• Severe pain
• Gross deformity of the wrist
• Significant swelling
• Limited or absent range of motion at the wrist joint itself
• Numbness or tingling in the hand/fingers if nerves are affected

Impact on Finger Movement

Given the anatomical separation, the muscles and tendons that control finger movement are generally not directly dislocated along with the carpal bones. Therefore, the potential for some degree of finger flexion and extension often remains.

However, several factors can severely impair or limit this movement:

• Excruciating Pain: The severe pain associated with a dislocated joint will naturally inhibit any attempt at movement, as the body's protective mechanisms prevent further injury.
• Swelling and Edema: Significant swelling around the wrist joint can compress the tendons as they pass through their sheaths, making it difficult for them to glide smoothly. This can cause stiffness and reduce the range of motion in the fingers.
• Nerve Compression or Damage: The median nerve and ulnar nerve both pass through the wrist area and are vulnerable to compression or direct trauma during a dislocation.
  • Median Nerve: Compression can lead to numbness, tingling, and weakness in the thumb, index, middle, and half of the ring finger, significantly impacting thumb opposition and finger flexion strength.
  • Ulnar Nerve: Damage can affect sensation in the little finger and half of the ring finger, and impair the function of many intrinsic hand muscles, affecting finger spreading and closing.
• Tendon Impingement: In rare or severe cases, displaced bones or torn ligaments could potentially impinge upon or directly damage the tendons, further restricting finger movement.
• Overall Instability: The gross instability and malalignment of the wrist joint make any coordinated movement originating from the forearm muscles difficult and painful.

Why Finger Movement Might Be Impaired (Even if Possible)

Even if the anatomical pathways for finger movement are not completely severed, the functional impairment stems from:

• Pain Inhibition: The body's natural response to severe pain is to guard and immobilize the injured area, making voluntary movement difficult or impossible.
• Mechanical Obstruction: Displaced bones and surrounding soft tissue swelling can create mechanical barriers, preventing the full excursion of finger flexor and extensor tendons.
• Neurological Compromise: As mentioned, nerve compression or injury is a significant concern. If the nerves supplying the finger muscles are affected, both motor control and sensation will be compromised.
• Vascular Compromise: While less common for finger movement specifically, severe dislocations can compromise blood flow, which indirectly impacts tissue health and function.

Immediate Actions and Medical Attention

A dislocated wrist is a serious orthopedic emergency requiring immediate medical attention. Do not attempt to reduce the dislocation yourself or manipulate the wrist.

• Immobilize: Gently support the injured wrist in the position it is found.
• Ice: Apply ice packs to help reduce swelling.
• Elevate: Keep the hand and wrist elevated above heart level.
• Seek Emergency Care: Go to the nearest emergency room or call for emergency medical services immediately. Prompt reduction of the dislocation is crucial to minimize complications like nerve damage, blood vessel compromise, and long-term joint stiffness.

Recovery and Rehabilitation

Once the wrist dislocation is medically reduced and stabilized (often with casting or surgery), a structured rehabilitation program is essential. This typically involves:

• Immobilization Phase: To allow initial healing.
• Gentle Range of Motion: Gradually restoring movement to the wrist and fingers.
• Strengthening Exercises: To rebuild strength in the forearm and hand muscles.
• Proprioception and Dexterity Training: To restore fine motor control and coordination.

Conclusion

While the muscles that move your fingers are distinct from the bones of the wrist joint, a dislocated wrist represents a significant traumatic injury. While some limited, painful finger movement may still be possible, it will be severely compromised by pain, swelling, and potential nerve involvement. Any suspected wrist dislocation warrants immediate medical evaluation to ensure proper diagnosis, reduction, and prevent long-term complications affecting both wrist and hand function.