A finger dislocation (phalangeal joint luxation) occurs when the bones in the finger separate from their normal alignment at a joint. This traumatic event forces the joint surfaces completely out of contact, often due to a strong impact or hyperextension. Safely managing a dislocated finger requires specific first aid followed by a professional medical procedure. This process focuses on immediate care, safe reduction, and structured rehabilitation to restore full function.
Recognizing a Dislocation and Initial First Aid
A dislocated finger presents with unmistakable signs requiring immediate attention. The most apparent symptom is a visible deformity, where the finger appears crooked or bent at an unusual angle. This misalignment is accompanied by intense, localized pain and rapid swelling around the joint capsule.
The affected joint will be immobile, though movement in the joints above and below the injury may remain. Immediately remove any rings or jewelry from the affected finger, as rapid swelling can compromise circulation.
To manage pain and control swelling, apply a cold compress or ice pack wrapped in a cloth to the injured area for about 20 minutes. Keep the hand elevated above heart level to minimize swelling. Gently immobilize the finger in the position you find it, using a simple splint or taping it to an adjacent finger, and seek medical attention without delay.
The Danger of Self-Correction
Resist the urge to “pop” or pull the dislocated finger back into place yourself. This attempted self-reduction carries a significant risk of turning a straightforward injury into a severe complication. The underlying anatomy of the finger is intricate, involving delicate structures easily damaged by untrained manipulation.
Forcing the bones back can cause further trauma, such as tearing the ligaments and tendons that stabilize the joint, particularly the volar plate. This manipulation can also damage the nerves and blood vessels, potentially leading to permanent numbness, restricted blood flow, or long-term joint instability.
A forceful attempt at correction can convert a simple dislocation into a complex injury, such as a compound fracture where the bone pierces the skin. A bone fragment or section of the joint capsule may also be trapped within the joint space, blocking a safe manual reduction and necessitating surgery.
Professional Medical Treatment: The Reduction Procedure
At a medical facility, the first step is typically an X-ray to confirm the dislocation and check for associated fractures. The most common treatment is closed reduction, a non-surgical procedure performed by a qualified healthcare professional. Adequate anesthesia is a prerequisite for a successful reduction.
A local anesthetic is often injected directly into the finger, or conscious sedation may be used to relax the surrounding muscles. The physician uses a specific manual technique involving gentle longitudinal traction—a steady pull along the length of the finger—to overcome muscle spasm and ligament tension. The doctor then applies pressure to the displaced bone, manipulating it back into the correct anatomical position.
After reduction, a second X-ray confirms that the bones are realigned and that no fragments are trapped within the joint. If the bones cannot be reduced or the joint is unstable, open reduction surgery may be necessary to repair torn ligaments or remove blocking fragments. The finger is then immobilized, often with a splint or by buddy taping it to an adjacent finger, to protect the newly aligned joint.
Rehabilitation and Long-Term Recovery
Following reduction, the finger must be immobilized to allow the damaged joint capsule and ligaments to heal. Splinting time varies but is usually limited to a few weeks, balancing stability against the risk of joint stiffness. Excessive immobilization can lead to long-term stiffness, which is common in the proximal interphalangeal (PIP) joint.
Early, protected movement is encouraged by a hand therapist to prevent permanent stiffness and maximize functional outcome. Rehabilitation involves gentle range-of-motion exercises, sometimes starting within days of the injury, to improve flexibility and reduce residual swelling. The goal is to regain the ability to make a full fist and fully straighten the finger.
While simple dislocations can heal in about six weeks, it may take three to six months for the finger to feel normal, with mild stiffness or discomfort lasting up to a year. Persistent numbness, instability, or ongoing severe pain beyond the initial healing period are signs that require follow-up with a hand specialist.