Dislocations Of The Finger - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing joint dislocations of the finger.
Metacarpophalangeal joint disloctions
•Dislocations of the metacarpohalangeal joint can be either simple or complex. Metacarpophalangeal joint dislocation with volar plate injury or entrapment.
•Simple dislocations are reducible and present with hyperextension posture. Some contact remains between the base of P1 and the metacarpal head. The volar plate stays volar. Reduction can be achieved with simple flexion of the joint.
•Complex dislocations (irreducible ): widened joint space due to entrapment of the volar plate/sesamoid in the joint space. Occurs more in the index finger.
•Dorsal dislocations are the most common. Usually stable after reduction. Volar dislocation are rare and particularly unstable and require surgery.
Proximal interphalangeal joint dislocations (PIP)
•Dislocation may be dorsal or volar.
•Dorsal dislocations are usually distal with or without a small flake of bone. Immobilize in flexion.
•Volar dislocations: long finger is the most common one dislocated followed by the ring finger. volar dislocation/central slip disruption. Immobilize in extension. It results in Boutonniere deformity if not treated properly.
•Irreducible dislocation: head of P1 protrudes between the central slip and one lateral band. It creates a noose effect preventing reduction especially if excessive traction is applied.
Distal interphalangeal joint fracture dislocations (DIP)
•Dorsal dislocations without tendon rupture are rare. They are unstable and should be immobilized in some flexion. Mallet finger deformity may be associated with an avulsion fracture. The patient is unable to straighten the DIP joint due to the avulsion injury of the extensor tendon. Check the stability of the joint.
•Treatment
Mallet finger with subluxation of DIP joint is an indication for surgery. May require closed reduction and pinning of the fracture or the joint.

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