A dislocated finger can lead to complex issues if left unaddressed. While prompt treatment offers the best outcome, it is sometimes possible to fix a dislocated finger years after the initial injury. Delayed treatment presents unique challenges due to changes within the joint and surrounding tissues.
Understanding Finger Dislocations
A finger dislocation occurs when the bones forming a joint are forced out of their normal alignment. Each finger contains three main joints: the metacarpophalangeal (MCP) joint at the base, the proximal interphalangeal (PIP) joint in the middle, and the distal interphalangeal (DIP) joint closest to the fingertip. The PIP joint is the most common site for dislocations. These joints, along with their supporting ligaments, joint capsule, and tendons, allow for the range of motion needed for grasping and pinching.
Dislocations often result from hyperextension or direct trauma, such as a ball striking an outstretched finger. The ligaments can be stretched or torn, allowing the bones to separate. Immediate reduction, or realignment of the bones, is performed to restore stability and prevent long-term complications.
Why Delayed Treatment Poses Challenges
When a dislocated finger remains unreduced, the body adapts to the abnormal joint position. Scar tissue forms around the joint, which can limit movement and make realignment difficult. This scar tissue can create adhesions, essentially “gluing” structures together.
The joint capsule, a fibrous sac enclosing the joint, can also undergo changes, becoming thickened and contracted. Ligaments and tendons surrounding the dislocated joint may shorten or tighten, further restricting movement. Cartilage within the joint can also suffer damage or degenerate due to abnormal pressure and friction. These cumulative changes increase the likelihood of chronic pain, persistent stiffness, and the development of post-traumatic arthritis.
Evaluating a Long-Standing Dislocation
Assessing a long-standing finger dislocation requires a thorough evaluation. A physical examination helps determine the finger’s current range of motion, stability, and any areas of tenderness or deformity. The healthcare provider also looks for signs like swelling, bruising, or dimpling of the skin, which might indicate soft tissue involvement.
Imaging techniques are important for understanding the extent of the injury. X-rays are used to visualize bone alignment, detect fractures, and assess joint integrity. For a more detailed assessment of soft tissue damage, such as torn ligaments, tendons, or cartilage, advanced imaging like Magnetic Resonance Imaging (MRI) is often necessary. MRI can reveal the presence of scar tissue, joint capsule changes, and other complicating factors.
Corrective Procedures and Options
Addressing a long-standing finger dislocation involves interventions beyond simple closed reduction. For chronic cases, conservative options like physical therapy alone are less effective due to tissue changes. The primary approach involves surgical intervention to restore joint alignment and function.
Surgical techniques vary depending on the extent of damage. An open reduction procedure involves a surgical incision to directly visualize the joint and manually realign the bones. Scar tissue restricting movement may be removed through arthrolysis, which involves dissecting adhesions and releasing contracted soft tissues. If ligaments are damaged or insufficient, reconstruction may use grafts to restore stability.
If joint surfaces are damaged or arthritic, fusion (arthrodesis) or replacement (arthroplasty) may be considered. Joint fusion permanently stabilizes the joint but eliminates movement, while arthroplasty replaces the damaged joint with an artificial one to preserve some motion. Procedure choice is individualized, based on the specific joint, dislocation duration, and associated injuries like fractures or severe soft tissue damage.
Post-Treatment Expectations
Following treatment for a long-standing dislocated finger, rehabilitation plays a key role in recovery. Physical therapy helps regain strength, flexibility, and range of motion. Exercises are designed to mobilize the joint and prevent new scar tissue from limiting movement.
Recovery timelines vary depending on injury severity and chosen treatment, but it may take months for swelling to resolve and function to improve. While significant improvement in pain and function is possible, especially with dedicated therapy, some residual stiffness or discomfort may persist, particularly in long-standing dislocations. Full pre-injury function may not always be achievable, but the goal is to optimize the finger’s utility for daily activities.