Interphalangeal Joint Dislocation of the Fingers and Toes Clinical Presentation

Updated: Dec 04, 2019
  • Author: Grace M Young, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Presentation

History

History usually reveals a traumatic athletic injury or entrapment of the finger between objects. Typically, the finger was jammed or bent backward during a basketball, football, or other sports activity. The patient often experiences diffuse pain, swelling, and tingling.

Determine the following aspects of the patient's history:

  • Which is the dominant hand of the patient and which hand is injured?

  • What is the patient's occupation?

  • Where did injury occur (eg, job, assault)?

  • How much time has passed since the initial injury?

Next:

Physical

An accurate and detailed examination often requires digital block anesthesia. The clinician should test and document each of the following [11, 12] :

  • Gross deformity, diffuse edema, ecchymosis, and tenderness of the involved digit

  • Possible anesthesia or paresthesia in the distal aspect of the involved digit

  • Range of motion, function, and stability of involved joint

  • Detailed neurovascular examination of the entire involved hand

Restriction in active flexion and extension, especially against resistance, suggests tendinous or ligamentous rupture or intra-articular osteochondral fragment.

Test the integrity of the volar plate by passive hyperextension.

Test the collateral ligaments by exerting radial and ulnar stress.

Skin laceration after a blunt hyperextension injury suggests volar plate rupture.

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