eMedicine Specialties > Sports Medicine > Wrist and Hand

Hand Dislocation: Multimedia

Author: Jeff Chan, MD, MS, FACEP, Clinical Instructor, Stanford University; Staff Physician, Department of Emergency Medicine, Regional Medical Center of San Jose
Coauthor(s): Eleby R Washington III, MD, FACS, Associate Professor, Department of Surgery, Division of Orthopedics, Charles R Drew University of Medicine and Science; Igor Boyarsky, DO, Director of Triage, Assistant Professor, Department of Emergency Medicine, King-Drew Medical Center, University of California at Los Angeles
Contributor Information and Disclosures

Updated: Mar 27, 2009

Multimedia

Carpometacarpal joint dislocation.Media file 1: Carpometacarpal joint dislocation.
Carpometacarpal joint dislocation.

Carpometacarpal joint dislocation.

Carpometacarpal joint dislocation.Media file 2: Carpometacarpal joint dislocation.
Carpometacarpal joint dislocation.

Carpometacarpal joint dislocation.

Volar proximal interphalangeal (PIP) joint disloc...Media file 3: Volar proximal interphalangeal (PIP) joint dislocation.
Volar proximal interphalangeal (PIP) joint disloc...

Volar proximal interphalangeal (PIP) joint dislocation.

Dorsal thumb interphalangeal dislocation.Media file 4: Dorsal thumb interphalangeal dislocation.
Dorsal thumb interphalangeal dislocation.

Dorsal thumb interphalangeal dislocation.

Dorsal thumb interphalangeal dislocation.Media file 5: Dorsal thumb interphalangeal dislocation.
Dorsal thumb interphalangeal dislocation.

Dorsal thumb interphalangeal dislocation.

Aluminum foam splints.Media file 6: Aluminum foam splints.
Aluminum foam splints.

Aluminum foam splints.

Hand dislocation. Dorsal aluminum foam splint.Media file 7: Hand dislocation. Dorsal aluminum foam splint.
Hand dislocation. Dorsal aluminum foam splint.

Hand dislocation. Dorsal aluminum foam splint.

Buddy taping.Media file 8: Buddy taping.
Buddy taping.

Buddy taping.

Acute dorsal proximal interphalangeal joint fract...Media file 9: Acute dorsal proximal interphalangeal joint fracture-dislocation.
Acute dorsal proximal interphalangeal joint fract...

Acute dorsal proximal interphalangeal joint fracture-dislocation.

Acute dorsal proximal interphalangeal fracture-di...Media file 10: Acute dorsal proximal interphalangeal fracture-dislocation. A concentric reduction could not be maintained in a splint.
Acute dorsal proximal interphalangeal fracture-di...

Acute dorsal proximal interphalangeal fracture-dislocation. A concentric reduction could not be maintained in a splint.

Complex second metacarpophalangeal dislocation in...Media file 11: Complex second metacarpophalangeal dislocation in a skeletally immature patient (same patient in Images 11-13). Note the position of the finger and dimpling of skin on volar hand.
Complex second metacarpophalangeal dislocation in...

Complex second metacarpophalangeal dislocation in a skeletally immature patient (same patient in Images 11-13). Note the position of the finger and dimpling of skin on volar hand.

Radiograph of the hand of the patient in Image 11...Media file 12: Radiograph of the hand of the patient in Image 11 (same patient in Images 11-13).
Radiograph of the hand of the patient in Image 11...

Radiograph of the hand of the patient in Image 11 (same patient in Images 11-13).

Intraoperative photo of the second metacarpophala...Media file 13: Intraoperative photo of the second metacarpophalangeal joint (same patient in Images 11-13). Note the displaced volar plate between the metacarpal head and the proximal phalanx.
Intraoperative photo of the second metacarpophala...

Intraoperative photo of the second metacarpophalangeal joint (same patient in Images 11-13). Note the displaced volar plate between the metacarpal head and the proximal phalanx.

Boutonniere deformity.Media file 14: Boutonniere deformity.
Boutonniere deformity.

Boutonniere deformity.

Normal lateral band location, dorsal to the axis ...Media file 15: Normal lateral band location, dorsal to the axis of rotation of the proximal interphalangeal joint.
Normal lateral band location, dorsal to the axis ...

Normal lateral band location, dorsal to the axis of rotation of the proximal interphalangeal joint.

After central slip disruption, lateral bands migr...Media file 16: After central slip disruption, lateral bands migrate volar to the axis of rotation of the proximal interphalangeal joint.
After central slip disruption, lateral bands migr...

After central slip disruption, lateral bands migrate volar to the axis of rotation of the proximal interphalangeal joint.

Lateral view of relevant finger anatomy.Media file 17: Lateral view of relevant finger anatomy.
Lateral view of relevant finger anatomy.

Lateral view of relevant finger anatomy.

Anteroposterior radiograph displaying a gamekeepe...Media file 18: Anteroposterior radiograph displaying a gamekeeper's fracture.
Anteroposterior radiograph displaying a gamekeepe...

Anteroposterior radiograph displaying a gamekeeper's fracture.

Lateral radiograph displaying a gamekeeper's frac...Media file 19: Lateral radiograph displaying a gamekeeper's fracture.
Lateral radiograph displaying a gamekeeper's frac...

Lateral radiograph displaying a gamekeeper's fracture.

Ruptured ulnar collateral ligament.Media file 20: Ruptured ulnar collateral ligament.
Ruptured ulnar collateral ligament.

Ruptured ulnar collateral ligament.

Completed UCL repair using suture anchors for fix...Media file 21: Completed UCL repair using suture anchors for fixation (same patient as in Image 20).
Completed UCL repair using suture anchors for fix...

Completed UCL repair using suture anchors for fixation (same patient as in Image 20).

Radiograph displaying a stress test of a torn uln...Media file 22: Radiograph displaying a stress test of a torn ulnar collateral ligament.
Radiograph displaying a stress test of a torn uln...

Radiograph displaying a stress test of a torn ulnar collateral ligament.

Complex unstable fracture of the proximal phalanx.Media file 23: Complex unstable fracture of the proximal phalanx.
Complex unstable fracture of the proximal phalanx.

Complex unstable fracture of the proximal phalanx.

Displaced fourth and fifth metacarpal fractures, ...Media file 24: Displaced fourth and fifth metacarpal fractures, anteroposterior view (same patient in Images 24-28).
Displaced fourth and fifth metacarpal fractures, ...

Displaced fourth and fifth metacarpal fractures, anteroposterior view (same patient in Images 24-28).

Displaced fourth and fifth metacarpal fractures, ...Media file 25: Displaced fourth and fifth metacarpal fractures, lateral view (same patient in Images 24-28).
Displaced fourth and fifth metacarpal fractures, ...

Displaced fourth and fifth metacarpal fractures, lateral view (same patient in Images 24-28).

Fourth and fifth metacarpal fractures, oblique vi...Media file 26: Fourth and fifth metacarpal fractures, oblique view (same patient in Images 24-28).
Fourth and fifth metacarpal fractures, oblique vi...

Fourth and fifth metacarpal fractures, oblique view (same patient in Images 24-28).

Fourth and fifth metacarpal fractures after intra...Media file 27: Fourth and fifth metacarpal fractures after intramedullary pinning, anteroposterior view (same patient in Images 24-28).
Fourth and fifth metacarpal fractures after intra...

Fourth and fifth metacarpal fractures after intramedullary pinning, anteroposterior view (same patient in Images 24-28).

Fourth and fifth metacarpals after intramedullary...Media file 28: Fourth and fifth metacarpals after intramedullary pinning, lateral view (same patient in Images 24-28).
Fourth and fifth metacarpals after intramedullary...

Fourth and fifth metacarpals after intramedullary pinning, lateral view (same patient in Images 24-28).

Digital block.Media file 29: Digital block.
Digital block.

Digital block.

More on Hand Dislocation

Overview: Hand Dislocation
Differential Diagnoses & Workup: Hand Dislocation
Treatment & Medication: Hand Dislocation
Follow-up: Hand Dislocation
Multimedia: Hand Dislocation
References
Further Reading

References

  1. Isani A, Melone CP Jr. Ligamentous injuries of the hand in athletes. Clin Sports Med. Oct 1986;5(4):757-72. [Medline].

  2. Kahler DM, McCue FC 3rd. Metacarpophalangeal and proximal interphalangeal joint injuries of the hand, including the thumb. Clin Sports Med. Jan 1992;11(1):57-76. [Medline].

  3. Lairmore JR, Engber WD. Serious, often subtle, finger injuries. Avoiding diagnosis and treatment pitfalls. Phys Sportsmed. 1998;26(6):57-69.

  4. Bach AW. Finger joint injuries in active patients: pointers for acute and late-phase management. Phys Sportsmed. 1999;27(3).

  5. Mall NA, Carlisle JC, Matava MJ, Powell JW, Goldfarb CA. Upper extremity injuries in the National Football League: part I: hand and digital injuries. Am J Sports Med. Oct 2008;36(10):1938-44. [Medline].

  6. Lubahn JD. Dorsal fracture dislocations of the proximal interphalangeal joint. Hand Clin. Feb 1988;4(1):15-24. [Medline].

  7. Hubbard LF. Metacarpophalangeal dislocations. Hand Clin. Feb 1988;4(1):39-44. [Medline].

  8. Gurland M. Carpometacarpal joint injuries of the fingers. Hand Clin. Nov 1992;8(4):733-44. [Medline].

  9. Inoue G, Maeda N. Irreducible palmar dislocation of the proximal interphalangeal joint of the finger. J Hand Surg [Am]. Mar 1990;15(2):301-4. [Medline].

  10. Kovacic J, Bergfeld J. Return to play issues in upper extremity injuries. Clin J Sport Med. Nov 2005;15(6):448-52. [Medline].

  11. Freiberg A, Pollard BA, Macdonald MR, Duncan MJ. Management of proximal interphalangeal joint injuries. J Trauma. Mar 1999;46(3):523-8. [Medline].

  12. McDevitt ER. Treatment of PIP joint dislocations. Phys Sportsmed. 1998;26(8):85-6.

  13. Melone CP Jr. Joint injuries of the fingers and thumb. Emerg Med Clin North Am. May 1985;3(2):319-31. [Medline].

  14. Thayer DT. Distal interphalangeal joint injuries. Hand Clin. Feb 1988;4(1):1-4. [Medline].

  15. Vicar AJ. Proximal interphalangeal joint dislocations without fractures. Hand Clin. Feb 1988;4(1):5-13. [Medline].

  16. Wilson RL, Liechty BW. Complications following small joint injuries. Hand Clin. May 1986;2(2):329-45. [Medline].

  17. Kiefhaber TR, Stern PJ, Grood ES. Lateral stability of the proximal interphalangeal joint. J Hand Surg [Am]. Sep 1986;11(5):661-9. [Medline].

  18. Best Evidence: Talsma E, de Haart M, Beelen A, Nollet F. The effect of mobilization on repaired extensor tendon injuries of the hand: a systematic review. Arch Phys Med Rehabil. Dec 2008;89(12):2366-72. [Medline].

  19. Durakbasa O, Guneri B. The volar surgical approach in complex dorsal metacarpophalangeal dislocations. Injury. Feb 18 2009;epub ahead of print. [Medline].

  20. Kneser U, Goldberg E, Polykandriotis E, et al. Biomechanical and functional analysis of the pins and rubbers tractions system for treatment of proximal interphalangeal joint fracture dislocations. Arch Orthop Trauma Surg. Jan 2009;129(1):29-37. [Medline].

  21. Liss FE, Green SM. Capsular injuries of the proximal interphalangeal joint. Hand Clin. Nov 1992;8(4):755-68. [Medline].

  22. Stern PJ, Lee AF. Open dorsal dislocations of the proximal interphalangeal joint. J Hand Surg [Am]. May 1985;10(3):364-70. [Medline].

Further Reading

Related eMedicine Topics

Best Evidence

Clinical Trials

National Guidelines Clearinghouse

Keywords

hand dislocation, broken finger, dislocated finger, injured finger, proximal interphalangeal joint dislocation PIP joint dislocation, distal interphalangeal joint dislocation, DIP joint dislocation, carpometacarpal joint dislocation, CMC joint dislocation, metacarpophalangeal joint dislocation, MCP joint dislocation

Contributor Information and Disclosures

Author

Jeff Chan, MD, MS, FACEP, Clinical Instructor, Stanford University; Staff Physician, Department of Emergency Medicine, Regional Medical Center of San Jose
Jeff Chan, MD, MS, FACEP is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Eleby R Washington III, MD, FACS, Associate Professor, Department of Surgery, Division of Orthopedics, Charles R Drew University of Medicine and Science
Eleby R Washington III, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Medical Association, International College of Surgeons, and National Medical Association
Disclosure: Nothing to disclose.

Igor Boyarsky, DO, Director of Triage, Assistant Professor, Department of Emergency Medicine, King-Drew Medical Center, University of California at Los Angeles
Igor Boyarsky, DO is a member of the following medical societies: American Medical Association, American Medical Student Association/Foundation, American Osteopathic Association, American Society of Addiction Medicine, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Gerard A Malanga, MD, Founder and Director, New Jersey Sports Medicine Institute; Director of Pain Management, Overlook Hospital; Director of Sports Medicine, Sports Medicine Fellowship Director, Mountainside Hospital; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Medical Director, Consultant, Horizon Healthcare Worker's Compensation Services, Blue Cross and Blue Shield Worker's Compensation
Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, North American Spine Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Cephalon Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Henry T Goitz, MD, Fellowship Director, Sports Medicine, Department of Orthopedic Surgery, Henry Ford Hospital
Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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