Hand and finger dislocations: Difference between revisions

Latest revision as of 17:35, 14 December 2022

Background

Distal interphalangeal dislocation (DIP), proximal interphalangeal dislocation (PIP), and metacarpophalangeal dislocation (MCP) joints of the finger shown.

Volar/anterior finger anatomy.

Lateral finger anatomy.

Hand Anatomy

Volar = anterior = palmar
Dorsal = posterior

Types

Hand and finger dislocations

Finger dislocations
Thumb dislocations
- Interphalangeal dislocation (thumb) (IP)
- Metacarpophalangeal dislocation (thumb) (MCP)
Hand dislocations
- Carpometacarpal dislocation

Clinical Features

Right fifth phalanx dislocation.

See individual injury types for specific clinical features
In general, there is some history of traumatic injury with pain at the dislocated joint

Differential Diagnosis

Hand and finger injuries

Distal finger
Other finger/thumb
- Boutonniere deformity
- Mallet finger
  - Swan neck deformity
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
Hand
- Dupuytren contracture
Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
General

Evaluation

Workup

Diagnosis

Management

See individual injury type for specific management
In general, dislocations should be emergently reduced and then splinted

Disposition

See individual injury type for specific disposition
In general, dislocations should all have orthopedic outpatient follow up after successful reduction

External Links

References

Authors:

@@ Line 1: / Line 1: @@
+==Background==
+[[File:DIP, PIP and MCP joints of hand.jpg|thumb|Distal interphalangeal dislocation (DIP), proximal interphalangeal dislocation (PIP), and metacarpophalangeal dislocation (MCP) joints of the finger shown.]]
+[[File:Gray337.png|thumb|Volar/anterior finger anatomy.]]
+[[File:Gray338.png|thumb|Lateral finger anatomy.]]
+{{Hand anatomy}}
 ==Types==
 {{Hand and finger dislocation types}}
-==MCP Ulnar Ligament Rupture==
+==Clinical Features==
-*Also known as gamekeeper's thumb or skier's thumb
+[[File:Dislocated Finger.jpg|thumb|Right fifth phalanx dislocation.]]
-*Ulnar ligament ruptures at insertion into prox phalanx (due to radial deviation of MCP)
+*See individual injury types for specific clinical features
-*X-ray (perform before joint stressing)
+*In general, there is some history of traumatic injury with pain at the dislocated joint
-**Bony avulsion from insertion of UCL into proximal phalanx
-**Associated condylar fracture
-**Proximal phalanx volar subluxation and radial deviation suggests complete UCL rupture
-*Exam
-**Swelling and localized tenderness over ulnar border of joint
-**Weakness of pinch
-**Partial versus complete rupture
-***Valgus stress testing with joint in full extension and in 30 deg of flexion
-****>35 deg of joint laxity or 15 deg of laxity beyond that present in uninjured thumb is consistent w/ complete UCL rupture
-====Management====
-*Partial rupture
-**Immobilize in [[thumb spica]] for 4wk
-*Full rupture
-**Referral within 1wk
 ==Differential Diagnosis==
 {{Hand and finger injury DDX}}
+==Evaluation==
+===Workup===
+===Diagnosis===
+<gallery mode="packed">
+File:MCCdislocation.png|[[Metacarpophalangeal dislocation (thumb)|MCP dislocation of thumb]]
+File:Dislocated Finger XRay.png|[[Proximal interphalangeal dislocation (finger)|PIP dislocation of right fifth phalanx]]
+</gallery>
+==Management==
+*See individual injury type for specific management
+*In general, dislocations should be emergently reduced and then splinted
+==Disposition==
+*See individual injury type for specific disposition
+*In general, dislocations should all have orthopedic outpatient follow up after successful reduction
 ==See Also==
 *[[Hand and Finger Diagnoses (Main)]]
+==External Links==
 ==References==
+<references/>
+[[Category:Orthopedics]]
-[[Category:Ortho]]