Finger dislocation is a common and painful injury. A dislocation occurs when the bone becomes dislodged from its normal position. Any of the finger bones — which are connected at the knuckles — can become dislocated, although it most commonly happens at the middle knuckle joint or proximal interphalangeal (PIP). It can difficult to distinguish between a dislocated and broken finger because the symptoms are often similar.

Common Causes

A force striking the end of the finger is the most common cause of a dislocated finger. Alternatively, the finger may be forcefully overextended or bent beyond its normal range of movement. Dislocated fingers are often the result of sports injuries, such as when a ball hits the end of a finger, or if a person falls on their hands and bends their finger back.

Symptoms

The most obvious symptom of a dislocated finger is severe pain. The finger will often appear very swollen and bruised. It may look crooked, sticking out at an unusual angle. If the dislocation is severe, it may affect sensation, causing numbness or tingling. The skin may look very pale. Very rarely, the bone may pierce the skin of the hand. If this happens, it is a medical emergency requiring immediate attention.

First Aid

A dislocated finger requires evaluation and treatment by a medical practitioner. However, some simple first aid measures can bridge the time between the injury and seeing a doctor. The person should not attempt to manipulate their finger back into its correct position. Removal of any rings is essential as they can lead to further damage should the finger begin to swell. A cold pack can minimize pain and swelling, and the individual should elevate the whole hand above the heart.

When to Seek Help

Anyone who thinks they may have a dislocated finger should seek medical attention as soon as possible. Delayed treatment can make recovery more difficult and may lead to long-term loss of movement. It is also possible the injury caused additional damage to the finger, such as a sprain or fracture. Though the individual should see a doctor regardless, immediate medical care is especially important if there is altered sensation in the finger, if the bone has pierced the skin, or if the area looks blue or pale, or feels cold.

Diagnosis

To diagnose a dislocated finger, the doctor will ask the patient about their symptoms and examine the injured finger. Depending on the severity, it may be immediately obvious a dislocation has occurred. However, the diagnosis will usually require x-ray confirmation, which will help the doctor assess the extent of the injury and determine whether the finger has also suffered a break.

Treatment

Often, a doctor will manually place the bones back into their correct position through a “reduction” procedure. This generally painful process usually requires an injection of local anesthetic. Once the procedure is complete, the doctor may take another x-ray to ensure the bone is back in place. The treated finger will usually need to remain in a splint during the healing process, which prevents reinjury. Alternatively, it may be “buddy taped” to the adjacent finger.

Surgical Treatment

Although it’s uncommon, some dislocated fingers require surgery, particularly if other injuries — specifically fractures — are present. In most cases, doctors do not recommend surgery unless other treatment methods have failed.

Recovery at Home

In the days following a finger dislocation, applying regular ice packs to the affected area can help reduce pain and swelling. Keeping the hand elevated using pillows or a sling can reduce inflammation and make the person more comfortable. The finger will need to remain splinted for three to six weeks depending on how well it heals and the severity of the injury. The person may be given anti-inflammatory medications to help manage pain.

Physical Therapy

Some people with dislocated fingers may need physical therapy, during which the therapist is likely to prescribe special exercises to help strengthen the finger and regain a normal range of motion. Heat and massage therapy can reduce pain, swelling, and stiffness as well.

Prognosis

In the majority of cases, it is quite simple for a doctor to place a dislocated finger back into its normal position. The injured person will usually make a full recovery and resume their usual activities in a few weeks, though discomfort and decreased range of motion may persist for up to 18 months. If the injury was severe, there may be some permanent stiffness or swelling around the finger joint. The person will also have a higher risk of arthritis in the affected area in later years.