Introduction
Hand dislocations occur when an external force causes the bones in the fingers or wrist to shift out of their natural alignment. These injuries often happen during sports, falls, work-related accidents, or car crashes. Common symptoms include severe pain, deformity, restricted movement, and potential loss of sensation. In some cases, the bones may realign on their own, while others may require medical intervention, either manually or surgically.
Anatomy
The hand is made up of five digits: four fingers and a thumb. The bones within each finger are called phalanges, with each finger containing three phalanges, except for the thumb, which has two. The hand also has five metacarpal bones, which connect to the wrist, while smaller bones form the wrist joint.
Each finger contains two interphalangeal (IP) joints, while the thumb has one IP joint. These joints enable the bending and straightening of fingers. The metacarpophalangeal (MCP) joints, commonly known as knuckles, allow for upward, downward, and lateral finger movements. The carpometacarpal (CMC) joints connect the hand to the wrist.
Ligaments hold these bones together, and tendons link muscles to the bones, allowing for movement. Blood vessels, nerves, and connective tissues are also vital components that contribute to hand function.
Causes
Hand dislocations occur when bones shift out of their normal position due to injury. While some bones naturally realign, others may need medical attention. Dislocations can also damage ligaments, tendons, blood vessels, nerves, or surrounding tissues.
These injuries are frequently caused by high-impact sports like football, basketball, and baseball, especially affecting the IP joints. Falls on outstretched hands often result in dislocations of the MCP and CMC joints. Work-related accidents and car crashes are additional common causes.
Symptoms
A hand dislocation typically results in immediate, intense pain and difficulty moving the hand. Swelling, bruising, and numbness may occur, along with visible deformity or misalignment of the bones.
Diagnosis
A doctor can diagnose a hand dislocation by assessing the patient’s symptoms and the circumstances of the injury. X-rays are often used to confirm the dislocation and identify any associated fractures.
Treatment
In some instances, dislocated joints may realign on their own. However, in other cases, a doctor may need to perform a procedure known as a closed reduction, in which the bones are repositioned without making any incisions.
Surgery
If closed reduction is unsuccessful due to trapped ligaments or tendons within the joint, open reduction surgery may be required. This surgical method involves removing the obstructions and realigning the joint properly.
Recovery
Recovery from a hand dislocation often involves splinting and physical therapy. The duration of recovery varies depending on the severity of the injury and the treatment method used. Recovery can take several weeks, and your doctor will provide guidance on what to expect during this period.
