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Interphalangeal Dislocation Follow-up

  • Author: Grace M Young, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
 
Updated: Nov 12, 2015
 

Further Outpatient Care

Apply ice and elevate the digit. Splint at all times. The patient should not participate in sports activities involving the hand.

The patient should have a follow-up evaluation with an orthopedist or hand specialist.

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Further Inpatient Care

Admission may be warranted as dictated by a hand consultant or concurrent injuries.

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Inpatient & Outpatient Medications

NSAIDs may be taken as needed.

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Transfer

If an orthopedic or hand specialist is not immediately available for consultation, transfer patients whose reductions are unsuccessful or those who have an unstable joint, open joint injury, or associated epiphyseal or avulsion fracture.[15]

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Deterrence/Prevention

Patients may use supportive taping during future sports activities.

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Complications

Complications are rare with early reduction, although persistent pain or swelling is common. Despite appropriate management with rest, ice, and elevation, pain and swelling may persist for 6-12 months.[7, 8]

Inadequate immobilization after reduction may result in redislocation.

Prolonged immobilization may result in muscle contracture.

Volar plate injury may lead to recurrent dislocation with chronic laxity, hyperextensibility (swan-neck deformity on active extension), or flexion contracture (pseudoboutonnière deformity without DIP hyperextension).

Late or delayed reduction commonly results in loss of joint motion, joint instability, and limitation of hand function.

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Prognosis

The prognosis is excellent with proper reduction and follow-up evaluation by orthopedic or hand specialist.

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Patient Education

For excellent patient education resources, visit eMedicineHealth's First Aid and Injuries Center. Also, see eMedicineHealth's patient education articles, Broken Finger, Broken Hand, and Broken Toe.

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Contributor Information and Disclosures
Author

Grace M Young, MD Associate Professor, Department of Pediatrics, University of Maryland Medical Center

Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

James E Keany, MD, FACEP Associate Medical Director, Emergency Services, Mission Hospital Regional Medical Center, Children's Hospital of Orange County at Mission

James E Keany, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, California Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Tom Scaletta, MD President, Smart-ER (http://smart-er.net); Chair, Department of Emergency Medicine, Edward Hospital; Past-President, American Academy of Emergency Medicine

Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

References
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  12. Gilbert TJ, Cohen M. Imaging of acute injuries to the wrist and hand. Radiol Clin North Am. 1997 May. 35(3):701-25. [Medline].

  13. Joyce KM, Joyce CW, Conroy F, Chan J, Buckley E, Carroll SM. Proximal interphalangeal joint dislocations and treatment: an evolutionary process. Arch Plast Surg. 2014 Jul. 41 (4):394-7. [Medline].

  14. Kozin SH. Fractures and dislocations along the pediatric thumb ray. Hand Clin. 2006 Feb. 22(1):19-29. [Medline].

  15. Kannan RY, Wilmshurst AD. Unstable proximal interphalangeal joint dislocations: another cause. Emerg Med J. 2006 Oct. 23(10):819. [Medline].

  16. Bindra RR, Foster BJ. Management of proximal interphalangeal joint dislocations in athletes. Hand Clin. 2009 Aug. 25(3):423-35. [Medline].

  17. Nanno M, Sawaizumi T, Ito H. Irreducible palmar dislocation of the proximal interphalangeal joint of a finger evaluated by magnetic resonance imaging: a case report. Hand Surg. 2004 Dec. 9(2):253-6. [Medline].

 
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Anteroposterior view of distal interphalangeal (DIP) joint dislocation
Lateral view of distal interphalangeal (DIP) joint dislocation
Oblique view of distal interphalangeal (DIP) joint dislocation
Oblique view of proximal interphalangeal (PIP) joint dislocation
 
 
 
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