Dislocation of the hand

There are many injuries, first let’s figure out what a dislocation is. With a strong external impact, the articular surfaces of the bones are displaced relative to each other. In this case, the joint capsule – the shell of the articulation of these bones – is stretched or torn. Displaced bones do not properly touch and remain in this position, causing pain and preventing normal movement of the limb. This is the dislocation.

In fact, such a diagnosis of “dislocation of the hand” does not exist, but there is the concept of dislocation of one of the bones that form the joint. The hand consists of many bones, usually at least 27, and sometimes more. The dislocation does not occur in the entire hand, but in some of the bones that form its skeleton. Some we can see – the bones of the phalanges of the fingers, and some are not, because they are located inside.

The diagnosis is made by determining which bones have shifted with the help of an x-ray. There are many such options. Most often, the injury occurs due to a fall, blow, or a sharp jerk by the hand.

Symptoms of dislocation of the hand

Not to notice a dislocation of the hand is quite difficult. Much depends on the extent of the damage, and not all symptoms will always be present. Therefore, even if there is only one, it is necessary to consult a traumatologist.

The very first symptoms of dislocation of the hand: pain and stiffness of movements. The pain does not go away, even if you keep your hand in a static position. And when you try to move the brush, it only intensifies. Due to the incorrect arrangement of the bones, the movements of the brush are limited, sometimes it completely stops working. This is the main difference from a bruise – after it, a limb can be moved, although it is painful.

In addition, edema and hematoma often develop. The color of the skin changes to bluish or red, due to the leakage of blood from damaged vessels, the brush looks swollen. Some people react especially strongly to a dislocation. They may have a fever, chills, and malaise.

Hand dislocation treatment

Before treating a dislocation of the hand, the damaged area is first anesthetized. For this, special anesthetics are injected.

Only after that, the dislocation is reduced: the displaced bones must be placed correctly, they themselves will not recover. The procedure can only be performed by a doctor, as incorrect movement can further damage the joint. The dislocation is usually reduced quickly, with a sharp movement, during which a click is heard. This confirms that the bones are in place.

Since the joint bag is damaged, the bones put in place will still “dangle”. In order for the tissues to recover, a plaster or orthosis is applied – a special device of varying stiffness that can be “adjusted” to fit your size. After that, the patient immediately goes home and wears a cast for another 3 weeks.

Sometimes the brush is fixed at an angle, and in this position it is about 3 weeks. Then the plaster is removed, the brush is placed in a straight position and fixed again for 3 weeks. This is necessary for complicated dislocations.

Displaced small bones of the hand are difficult to correct conservatively. Especially if the ligaments are torn and the bones are twisted. Then an operation under anesthesia is required, where the reduction procedure is performed by the surgeon. After the wound is sewn up, and the brush is also fixed. A person is discharged from the hospital on the 3rd – 5th day.

While wearing a cast, the sensitivity of the fingers is checked, determining whether the nerves are damaged. For pain, painkillers are prescribed.

After removing the plaster, the hand is “developed”, since it has been motionless for a long time. To speed up the process, they are engaged in physiotherapy exercises, physiotherapy is prescribed. They increase blood flow, relieve swelling and accelerate healing.

Diagnostics

In the emergency room, a traumatologist or surgeon will examine the injured arm and check its mobility. Immediately after, an x-ray is taken to see how the bones are positioned.

Sometimes this is not enough, especially if it is not possible to correctly position the tucked limb under the apparatus. In this case, they may resort to the help of computed tomography or magnetic resonance therapy – CT and MRI. These apparatuses also show soft tissues and ligaments.

If a joint infection is suspected, a blood test is also ordered. This is possible if the skin has been damaged. If the infection is confirmed, antibiotics may be needed.

Modern treatments

Anesthesia and “closed” reduction of the bones of the hand are considered a conservative method. That is, the procedure is performed by a doctor without surgical intervention, without opening the skin and other tissues.

After this, recovery is usually quite fast, but the risk of complications is much higher. The doctor cannot see exactly how the tissues are damaged, and additionally fix the bones from the inside. Sometimes the hand does not fully restore mobility, or partially loses sensitivity. At the same time, the pain in the arm also disappears much longer, the development of arthrosis is possible – a change in the articular cartilage.

A more reliable method is the “open” method of treatment. Under anesthesia, the patient is operated on, the dislocation is reduced, and pins are placed to hold the bones in the correct position. Despite the traumatic procedure and further removal of the wires, the injury heals faster and complications develop less frequently.

Regardless of the method of repositioning the bones, after removing the plaster, the victim is assigned special procedures. Physiotherapy (for example, electrophoresis), massage.

The hand is complex, and in order to restore its functions and fine motor skills, it is necessary to re-develop it with the help of physiotherapy exercises. You should not overwork your hand too much, otherwise you can only worsen the condition.

Strengthen blood circulation will help sliding movements from the fingers to the forearm during the massage. And physiotherapy is aimed at accelerating the healing process and removing swelling.

Prevention of dislocation of the hand

Can this injury be avoided at all? Is there a way to prevent dislocation of the hand?

You can reduce the risk of injury by strengthening the ligaments. All bones are held together by ligaments, and the stronger the muscles and the stronger the ligaments, the less likely the bones are to move on impact. People at risk – athletes, active children – can do physical exercises to strengthen their hands. It is important not only to develop muscles, but also to do stretching exercises.

Some people are naturally flexible and tend to dislocate more often because the ligaments do not hold the joint well. Knowing about this feature, you need to develop muscle strength.

If the injury does happen, you should definitely consult a doctor, and not wait for it to go away on its own. To reduce swelling and pain, immediately apply a cold compress to the damaged area, and fix the brush with an elastic bandage. The cold must be periodically removed so as not to freeze the tissues. You don’t have to try to move your hand.

Popular questions and answers

Hand injuries account for up to 20% of all injuries that are usually treated in emergency rooms. This widespread injury raises a number of questions. We will find out from a specialist what are the symptoms of a dislocation of the hand, whether it can simply be overlooked. Answers frequently asked questions from patients traumatologist-orthopedist Sergey Prokofiev.