WHAT YOU SHOULD KNOW
The small joints of the hand and fingers are easily injured during sports, work, or even everyday activities. Ligament damage may be partial or complete. Even after a full dislocation, the main problem usually experienced is not an unstable joint. Stiffness is the main concern.
MEDICAL HISTORY
Patients usually can name the specific event that caused the injury, noting pain, swelling, stiffness and sometimes deformity immediately after. Patients often come to the office as late as several months following injury when these symptoms have failed to go away.
EXAMINATION
Visible swelling, loss of motion, and tenderness are usually present. The small joints are rarely unstable to testing under stress.
ADDITIONAL TESTS
Plain x-rays are taken to prove that there are no associated fractures.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL OPEN REDUCTION | |
| CONSISTS OF | Brief splinting followed by early motion | Short incision to put the dislocated joint back in place |
| FEATURES | Daily exercises specifically concentrated on the affected joint | Obstruction that prevented joint from being relocated to proper position must be removed from creating blockade |
| ADVANTAGES | Minimizes long-term stiffness | Achieves joint reduction |
| DISADVANTAGES | Cannot reduce a locked dislocation | Added stiffness |
RECOVERY
Research on small joint injuries reports that patients experience visible enlargement of the joint, aching pain, and stiffness for more than a year after the original injury. Therapists instruct patients on specific motion exercises of the stiff joint that should be performed every hour. If a contracture has already set in, powerful splints that gradually stretch out the contracture may be prescribed. Athletes may need to take precautions during training for the first 6-8 weeks after injury. Nearly all other normal activities of life can be resumed almost immediately after injury despite the symptoms.
