Distal interphalangeal dislocation (finger): Difference between revisions
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{{Hand and finger dislocation types}} | {{Hand and finger dislocation types}} | ||
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==Management== | ==Management== | ||
Revision as of 22:37, 21 July 2016
Background
- Uncommon due to firm attachment of skin and subq tissue to underlying bone
- When dislocations do occur usually are dorsal
Clinical Features
Differential Diagnosis
Hand and finger dislocations
- Finger dislocations
- Thumb dislocations
- Hand dislocations
Evaluation
Management
- Consider digital block for pain control
Dorsal/Posterior
- Flex wrist, then hyperextend the joint
- Apply longitudinal traction followed by dorsal pressure to phalanx base
- Irreducible dislocation likely due to entrapment of avulsion fracture, profundus tendor or volar plate
- Without initial hyperextension, can be difficult to disengage from any trapped soft tissue
- Post reduction, look for central slip rupture, which may lead to Boutonniere deformity
Volar/Anterior
- Flex wrist then hyperflex the affected joint
- Apply gentle traction then extend the joint
- Often need open reduction due to volar plate entrapment
Splinting
- Splint in slight flexion with dorsal splint x 3wk