A finger dislocation, also known as a volar plate injury, can happen in the blink of an eye and can result in a wide range of symptoms from mild ache to an unstable painful joint. Finger dislocations are often seen in sports, and most commonly from volleyball, basketball, baseball, and dodgeball.
Why not to take a finger dislocation lightly
The volar plate is a large ligament attaching between the proximal and middle phalanx (bottom and middle bones of a finger) and it prevents hyperextension of the Proximal Interphalangeal (PIP) joint, which is the middle joint of the finger. Finger dislocation happens when an external force is applied to the finger and overpowers the strength of the ligaments. Stress placed on the volar plate causes trauma to the PIP joint, leading to significant pain, bruising, swelling and stiffness. Dislocations cause a visible deformity of the digit and can occur in one of three ways: dorsal, volar, or lateral. Dorsal dislocations are the most common and place significant stress on the volar plate. The volar plate can be stretched, partially torn or can tear a small portion of the bone off causing an avulsion fracture. Early intervention is key to a successful outcome and a pain free finger in the long term. It is important to note that even if the joint did not completely dislocate, significant damage might have occurred to the volar plate requiring early intervention.
How to treat a dislocated or sprained finger?
Conservative treatment for dislocated fingers is highly successful. However, the classic aluminum splint with the blue foam is rarely (basically never) the answer. Treatment options are dependent on the joint stability and severity of the tear. A minor volar plate sprain can be treated with buddy taping to the adjacent finger, with tape placed above and below the PIP joint. Full movement is allowed and encouraged. A more significant injury will be treated with a dorsal blocking orthosis, placing the PIP joint in a bent position (20 to 30 degrees of flexion) to take tension off the volar plate and allowing it to heal. During the initial 3 to 6 weeks after injury, it is most important to protect the ligament, manage swelling with compression wrap and begin gentle range of motion exercises. Due to the complexity of the joint, complete immobilization is not recommended as it can lead to a very stiff and painful joint. After the initial period the focus shifts to regaining full range of motion and patient education for a safe return to sport. Volar plate injuries usually take about 6 to 8 weeks to heal, but sometimes longer. Your hand therapist will carefully assess your finger to determine which treatment option is best for your injury and guide you through the necessary steps. If you have sustained a finger dislocation, book an appointment today with one of our hand physiotherapists in Edmonton!