How to Identify and Treat Finger Sprains and Dislocations

Finger sprains and dislocations are common hand injuries that can happen during work, physical/sports activities, or in automobile collisions and accidents. Can recognizing the symptoms help in developing an effective treatment strategy?

Finger Sprains and Dislocations

Finger sprains and dislocations are common injuries of the hand that cause pain and swelling.

• A sprain happens when the finger tissue that supports a joint gets stretched beyond its limits in a way that stresses the ligaments and tendons.
• The ligament tissue can be partially or completely torn. If the damage is bad enough, the joint comes apart.
• This is a dislocation – A dislocation happens when the joint in the finger gets shifted out of its normal position.
• Both injuries can cause pain and stiffness in the finger and hand.

Sprains

Finger sprains can happen any time the finger bends in an awkward or unusual way. This can happen from falling on the hand or getting hurt when engaged in physical activities like sports or household chores. Sprains can occur in any of the knuckle joints in the finger. However, most commonly, the joint in the middle of the finger gets sprained. It’s known as the proximal interphalangeal or PIP joint. (John Elfar, Tobias Mann. 2013) Symptoms of a finger sprain can include:

• Pain when you move your finger
• Swelling around the knuckle
• Tenderness in the finger and around the joint
• For a sprain, individuals may need to have imaging done to see if any of the bones in the hand are broken or fractured. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)

Treatment

Individuals are encouraged not to move the injured finger while in recovery and healing. It can be hard to do, but wearing a splint can help.

• Splints are supports that are usually made from foam and pliable metal.
• A sprained finger can also be taped to one of the fingers next to it while in recovery, known as buddy-taping.
• Splinting a sprained finger while engaged in activities can protect the hand from worsening or further injury.
• However, splinting the finger when it is not needed can cause the joint to become stiff. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)

1. An injury known as “gamekeeper’s thumb” is a more serious type of sprain.
2. Injury to the ligaments at the thumb joint can cause difficulty in pinching and gripping.
3. This injury must often be taped up or splinted for a significant amount of time for full recovery and could require surgery. (Chen-Yu Hung, Matthew Varacallo, Ke-Vin Chang. 2023)

Other treatments to help a sprained finger include:

• Elevate the hand if swelling and inflamed.
• Gentle finger exercises/movements to prevent stiffness.
• Icing the injured finger.
• Take an anti-inflammatory medication.

Individuals who have not broken bones or dislocated the joint will probably be able to move their finger in about a week. A doctor will set a timeline for when to start using the finger normally.

1. Individuals who sprain their finger that feels swollen and stiff for longer than a few weeks are recommended to consult a doctor or specialist.
2. They will need to check the hand to make ensure there aren’t any breaks or fractures. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)
3. Thumb sprains and finger sprains in children may need to be splinted or taped for longer periods, as the ligament is not fully developed or as strong, which could lead to a tear.

Dislocations

A finger dislocation is a more severe injury involving the ligament, joint capsule, cartilage, and other tissues that causes misalignment of the finger. The ligaments and the joint capsule get torn when a joint is dislocated. The joint needs to be reset, which can be a simple process, or in severe cases, patients may need to be placed under anesthesia or undergo surgery to reset the joint properly.

• In these cases, tendons or other tissues might be preventing the joint from getting into position.
• Putting the finger back into the right position is known as”reduction.” Once reduced, the finger needs to be splinted.
• Individuals also need an X-ray to ensure the joint is lined up correctly and that any bones were not broken or fractured when they sustained the injury. (James R. Borchers, Thomas M. Best. 2012)
• Once reset, caring for a dislocated finger is basically the same as a sprained finger. Using ice on the finger, keeping the hand elevated to reduce swelling.
• Individuals need to check with their doctor to find out when to start moving the finger. (James R. Borchers, Thomas M. Best. 2012)

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References

Elfar, J., & Mann, T. (2013). Fracture-dislocations of the proximal interphalangeal joint. The Journal of the American Academy of Orthopaedic Surgeons, 21(2), 88–98. doi.org/10.5435/JAAOS-21-02-88

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Hand fractures.

Hung, C. Y., Varacallo, M., & Chang, K. V. (2023). Gamekeeper’s Thumb. In StatPearls. StatPearls Publishing.

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Finger fractures.

Borchers, J. R., & Best, T. M. (2012). Common finger fractures and dislocations. American family physician, 85(8), 805–810.