Dislocated Finger: Immediate Protection, Care, and Rehabilitation

How do you protect a dislocated finger?

Protecting a dislocated finger involves immediate immobilization and professional medical assessment, followed by a structured rehabilitation protocol focusing on controlled mobilization, strengthening, and gradual return to activity to prevent re-injury and restore full function.

Understanding a Dislocated Finger

A finger dislocation, medically known as a phalangeal dislocation, occurs when the bones of the finger (phalanges) are forced out of their normal alignment at a joint. This typically happens due to a direct impact or hyperextension, common in sports like basketball, volleyball, or contact sports. The most commonly dislocated joint is the proximal interphalangeal (PIP) joint, the middle joint of the finger. When a dislocation occurs, the ligaments supporting the joint are stretched or torn, leading to instability, pain, swelling, and often a visible deformity.

Immediate Protection and Care

The initial management of a dislocated finger is crucial to prevent further damage and facilitate proper healing.

• Do Not Attempt Self-Reduction: Unless you are a trained medical professional, never try to "pop" the finger back into place yourself. Improper reduction can cause further damage to ligaments, tendons, nerves, or blood vessels, or even fracture the bone.
• Immobilize Immediately: Gently support the injured finger in its current position. You can use a makeshift splint (e.g., a pen or popsicle stick taped loosely to the finger) or buddy tape it to an adjacent, uninjured finger to prevent movement.
• Apply R.I.C.E.:
  • Rest: Avoid any movement of the injured finger.
  • Ice: Apply an ice pack (wrapped in a cloth to prevent frostbite) for 15-20 minutes every 2-3 hours to reduce swelling and pain.
  • Compression: Lightly wrap the finger with an elastic bandage, ensuring it's not too tight to cut off circulation.
  • Elevation: Keep the hand elevated above heart level to minimize swelling.
• Seek Prompt Medical Attention: It is imperative to see a doctor or visit an urgent care facility as soon as possible. A medical professional will confirm the dislocation with an X-ray (to rule out fractures) and perform a proper reduction.

Post-Reduction Protection Strategies

After the finger has been successfully reduced (put back into place), the focus shifts to protecting the joint during the healing phase.

• Professional Splinting/Taping: Your doctor will likely apply a splint or tape the finger to immobilize the joint and allow the damaged ligaments to heal.
  • Splinting: Depending on the severity and joint involved, a custom or pre-fabricated splint may be used to hold the finger in a specific position, often for 2-6 weeks. The splint protects the joint from re-dislocation and allows ligamentous healing.
  • Buddy Taping: For less severe dislocations or as a transition from a rigid splint, buddy taping involves taping the injured finger to an adjacent healthy finger. This provides support and protection while allowing some controlled movement. Ensure the tape is not too tight and a small piece of gauze or padding is placed between the fingers to prevent skin irritation.
• Activity Modification: Avoid activities that put stress on the healing joint.
  • Avoid Gripping and Pinching: Refrain from strong gripping, pinching, or lifting heavy objects with the affected hand.
  • Protect During Sleep: Be mindful of the hand's position during sleep to avoid accidental re-injury.
  • Sport-Specific Restrictions: For athletes, a period of complete rest from sports is necessary, followed by a gradual return under medical guidance.
• Pain and Swelling Management: Continue using ice as needed, and over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and inflammation.

Rehabilitation and Strengthening

Once the initial healing phase is complete and the joint has regained some stability, a structured rehabilitation program is essential to restore full function and prevent future dislocations. This is often guided by a physical or occupational therapist.

• Gradual Range of Motion (ROM) Exercises:
  • Passive ROM: Gentle movements performed by the therapist or the uninjured hand to prevent stiffness without stressing the healing ligaments.
  • Active ROM: Controlled movements performed by the patient once appropriate, focusing on regaining full flexion and extension of the finger.
• Strengthening Exercises: As healing progresses, resistance exercises are introduced to strengthen the muscles surrounding the finger and hand.
  • Isometric Exercises: Gentle contractions without movement.
  • Elastic Band Exercises: Using resistance bands for finger flexion and extension.
  • Grip Strengthening: Squeezing a soft ball or putty.
  • Pinch Strengthening: Using small objects or putty for various pinch grips.
• Proprioception and Coordination: Exercises to improve the joint's sense of position and movement, crucial for preventing re-injury. This might include fine motor tasks or balance exercises for the hand.
• Functional and Sport-Specific Training: Gradually reintroducing activities that mimic daily tasks or sport movements, ensuring the finger can withstand the required forces. This includes catching, throwing, or gripping drills, progressively increasing intensity.

Preventing Re-Dislocation

Prevention is key once the finger has healed.

• Proper Technique: In sports, ensure correct hand positioning and technique, especially when catching or blocking.
• Protective Taping/Bracing: For individuals involved in high-risk sports, continued prophylactic (preventative) buddy taping or the use of a specialized finger brace can provide additional support and reduce the risk of re-dislocation.
• Maintain Hand Strength and Flexibility: Regular hand and finger exercises, even after recovery, can help maintain joint stability and resilience.
• Awareness: Be mindful of your hand's position during activities that could lead to impact or hyperextension.

When to Seek Professional Medical Attention

While immediate medical attention for a dislocation is a given, there are specific instances during recovery or if new symptoms arise that warrant further professional evaluation:

• Persistent Pain or Swelling: If pain or swelling does not subside with rest and R.I.C.E. or worsens.
• Numbness or Tingling: Indicates potential nerve damage.
• Inability to Move the Finger: After the initial immobilization period, if you cannot move the finger through its full range of motion.
• Signs of Infection: Redness, warmth, increased pain, pus, or fever.
• Re-Dislocation: If the finger dislocates again.
• Persistent Instability: If the finger feels "loose" or unstable even after rehabilitation.
• Lack of Progress: If you are not seeing improvement in strength, range of motion, or pain levels as expected during rehabilitation.

Protecting a dislocated finger is a multi-stage process that begins with immediate, appropriate first aid and extends through a disciplined rehabilitation program. Adhering to medical advice and a structured recovery plan is paramount to ensuring optimal healing, restoring function, and minimizing the risk of future injury.