Reduction of a Thumb Dislocation
A forceful trauma (e.g., sports injury or fall) to any of the figure joints can result in finger dislocation (movement of bone out of its original position). The thumb consists of only two joints, whereas the other four fingers consist of three joints, which allow it to bend forward, downward, and sideways. These joints are:
- Interphalangeal (IP) joint: It is located closest to the fingernails.
- Metacarpophalangeal (MCP) joint: It is located at the base of the thumb.
Thumb dislocations are usually caused by bending the thumb backward (hyperextension) beyond its normal range. They are the most common type of hand injuries that happen in athletes playing football and basketball while catching or blocking the fast-moving ball.
Although a thumb dislocation is not a medical emergency, delaying its treatment might increase the swelling in the finger, making the treatment difficult.
Thumb dislocation surgery is mainly done in cases of injury to the patella either sustained through sport, fall from height, fight, etc.
Possible risks of this procedure include:
- Fracture of the thumb
- Injury to the adjacent nerves or arteries
- anaesthesia side effects like headache, nausea and confusion
- infection
- bleeding and blood clots
- damage to nerves or blood vessels
If your thumb dislocation is not severe, the doctor can immediately fix it by externally manipulating and putting your bone back in its original position. This is known as a closed reduction. Before they do this, you might get a local anaesthetic medication to numb your thumb and an analgesic to ease your pain.
During the procedure, the doctor will gently restore your thumb to its correct position by gently pushing or pulling it. The procedure will vary depending upon which of the two joints (interphalangeal [IP] and metacarpophalangeal [MCP]) are dislocated. The doctor will perform another X-ray to confirm the success of the reduction procedure.
Once your thumb is back in its normal position, it will be wrapped in a splint or spica cast for three to six weeks.
Your doctor will look at the repeat X-ray of your thumb and will confirm the restoration of your thumb joint to its normal position.
Your doctor will teach you some exercises to be performed at home to restore the normal strength and range of motion in your thumb.
If you continue to have severe thumb pain after closed reduction or if your injured thumb is loose and unstable, you may require surgery to fix your dislocated thumb. The reduction is performed by opening your thumb, and the method is known as open reduction.
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