Hand dislocation is a common injury in sports and in occupational settings, often appearing to be minor. If the athlete, trainer, or coach has already reduced the dislocation, it appears unimpressive compared with a major knee injury or a shoulder dislocation.
However, hand dislocations have real potential for long-term disability in sports and other areas of life if adequate reduction is not performed, if associated injuries are not identified and appropriately treated or referred, and if potential complications of the injury and its treatment are not foreseen. The judgment of the initial treating physician can be critical in determining the long-term outcome of these injuries.
Many hand dislocations can be effectively treated with closed reduction, traction, or both. Grossly unstable joints and those for which closed reduction has failed typically require surgical intervention. Physical and occupational therapy are key components of treatment throughout. Any long-term complications (usually involving stiffness or instability) that develop must be addressed.
Causes
Hand dislocations cause the bones in the hand to move out of their normal position. The bones may spontaneously return to position or they may need realignment by a doctor. A hand dislocation may also injure the ligaments, tendons, blood vessels, nerves, and connective tissues.
Hand dislocations are most commonly caused by injuries during sports, such as football, basketball, and baseball. Interphalangeal joint dislocations occur most frequently during sports. Falls on an outstretched hand are most likely to cause MCP and CMC joint dislocations. Job-related injuries and motor vehicle crashes can also cause hand dislocations.
Symptoms
A hand dislocation causes pain at the time of injury. Your hand will be extremely painful when you attempt to move it. You may not be able to or may have difficulty moving your hand. Your hand may bruise, swell, or feel numb. Displaced bones may cause your hand to look odd or crooked.
Diagnosis
Your doctor can identify a hand dislocation by reviewing your medical history and examining your hand. You should tell your doctor about your symptoms and how your injury occurred. X-rays can show the dislocation and possible associated fractures.
