Dislocations of the thumb and fingers are common. Dislocations occur when a large force, pushes the bone out of its normal position. It is important that you seek immediate medical attention to relocate your bones back into the correct position as soon as possible. The bone can be dislocated in front, back and side movements. This does a lot of damage to the ligamentous structures around the joints. It makes your joints unstable and the joints swell up quite a lot.
Usually the volar plate and at least one collateral ligament will be torn with a dorsal finger dislocation. It can also be associated with a fracture. The volar plate is a thick ligament that prevents your finger from going backwards (hyperextension). This injury leads to instability of your middle knuckle joint, meaning you may experience excessive side-to-side and up and down movements. It is important to treat these conditions early with the correct positioning and stability exercises, so you are not left with a deformity. You will need to immobilise your finger initially in a dorsal blocking splint with your finger bent at 30 degrees. Your therapist will provide you with the necessary range of motion and strengthening exercises. Your finger may be taped to help you return to sport and everyday tasks quickly as shown in the picture.
This injury is often referred to as ‘Skier’s’ thumb or ‘Gamekeeper’s’ Thumb. The most common mechanism of injury is where your thumb is caught or pulled backwards. The thumb ligament provides stability to your thumb joint so you can pick up things easily. It takes 8 weeks for a torn ligament to heal. Surgical intervention may be required if there is a complete tear to the ligament and it has pulled out of its sheath (Steiner Lesion). These are rare.
Initially, your therapist will immobilise your thumb in a splint to provide protection and support of the ligament and teach you range, strength and proprioception exercises to ensure you regain your thumb’s full stability. Your thumb may be taped to help you return to sport and everyday tasks quickly as shown in the picture.
Your therapist will be able to provide you with the appropriate methods to initially immobilise and support the joint to allow for healing then provide you with an individualised treatment program.