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Joints in script , thumb and fingerbreadth include carpometacarpal ( Wrist ) joint , metacarpophalangeal ( knuckle joint ) joint and interphalangeal ( finger ) joint . Metacarpal bones lie in medallion of the hand and phalanges Trygve Halvden Lie in thumb and fingerbreadth . Dislocation of the joint in hand , ovolo and finger are often seen follow sport injury and domestic fall . disruption is cause by direct forceful shock , emphatic wrench of the pearl of the joint or high-pitched - energy muscle contraction in opposing counselling . disruption of the joint may be associated with cracking of the metacarpal bone or phalanx . associate soft tissue injury such as tendon and ligament bust or dislocation is often ignore during the examination and later during intervention .
Hand is made up of several bones and juncture . Hand is divided in palm , ovolo and fingers . Total number of bone find oneself in palm , thumb and fingers are 19 .
marijuana cigarette is a connexion between proximal and distal bones . Dislocation is a hoo-ha of the link result in detachment of proximal and distal pearl .
The Hand and Fingers Have 14 Joints as Described Below
Distal Interphalangeal (DIP) Joints1– 4 Joints (Excludes Thumb)
Proximal Interphalangeal (PIP) Joints2– 4 Joints (Excludes Thumb)
Dislocations of the Thumb Interphalangeal (IP) Joint- 1 Joint
Metacarpophalangeal (MP) Joint- 5 Joints (Includes Thumb).
Types of Dislocation of Hand, Thumb and Fingers
The breakdown of joints in hand , pollex and finger are anterior , posterior or sidelong . disruption or separation of link need proximal and distal osseous tissue . Proximal osseous tissue is reckon in normal anatomical berth if not fractured . Dislocation is classified as anterior , posterior or lateral depending on position of distal dislocated pearl . In rare cases multiple disruption of digit is realise and treated.3
Anterior Dislocation of Hand, Thumb and Fingers
Distal dislocated pearl lies anterior or ventral to proximal ivory . disjointed distal bone is considered as prior dislocation when distal osseous tissue is shifted towards front surface of palm , thumb , or fingers .
Posterior or Dorsal Dislocation of Hand, Thumb and Fingers
Distal disjointed bone lies later or dorsal to proximal bone . Dislocated distal ivory is considered as ulterior dislocation when distal pearl is shifted towards back surface of palm , thumb , or fingers .
Lateral Dislocation of Hand, Thumb and Fingers
Distal dislocated bone lies on inner or outer side of the proximal bone . Dislocated distal pearl is debate as sidelong breakdown when distal bone is shifted to privileged or outer side of palm , pollex , or digit .
Risk Factors for Dislocation of Hand, Thumb and Fingers
Obesity
Sedative Effects of Medications
Rheumatoid Arthritis
Position Of The Hand At The Time Of Fall
Anterior , ulterior or lateral disruption depends on the position of the bridge player and finger at the metre of wallop .
Causes for Dislocation of Hand, Thumb and Fingers
Symptoms for Dislocation of Hand, Thumb and Fingers
1. Acute and Chronic Pain Causing Dislocation of Hand, Thumb and Fingers
pain in the neck is either acute painful sensation or continuing pain . Acute pain last for less than 3 to 6 months and chronic nuisance last for more than 3 to 6 months .
Dislocation of Joints in Palm-
disruption of Joints In Thumb And Fingers-
Pain intensity is valuate as optical analog grievance ( VAS ) . VAS zero is consider as no nuisance and VAS of 10 is reckon as very hard pain . Pain is divided as mild , moderate , terrible and very severe pain . nuisance is severe to very severe following MP or IP joint dislocation .
2. Joint Deformity in Hand and Fingers4
Patient complains of joint deformity in palm or finger .
Distal fragment of the finger is displaced resulting in prior , posterior or sidelong dislocation . The type of deformity observed on examination is anterior , posterior or lateral deformity .
3. Unable to Bend Finger
Patient complaint of difficulties in bending or moving finger’s breadth at knuckles or mid fingers .
Patient is unable to move finger at PIP ( middle fingerbreadth ) and DIP ( distal finger and ovolo ) join .
Patient is unable to move finger at knuckles .
Signs for Dislocation of Hand, Thumb and Fingers
1. Bruising Of the Skin Covering Dislocation
2. Difficulties In Moving Hand And Fingers
Patient is ineffective to move fingers or thumb following disruption of the joint in palm , thumb or hand .
3. Deformity or Crooked Fingers
4. Tenderness
5. Inability To Grab The Object
Patient with dislocation of Metacarpophalangeal joint is ineffectual to grab any object in helping hand .
Patient will be able to give the object in palm with the use of normal fingerbreadth .
Investigations To Evaluate Dislocation Of Hand And Fingers
X-Ray Examination Of Hand And Fingers To Evaluate Dislocations
X - shaft examination is perform to value dislocation of Interphalangeal ( IP ) Joint and Metacarpophalangeal ( MP ) Joint .
MRI of Hand and Fingers To Evaluate Dislocations
MRI may not be necessary to diagnose breakdown of hand and fingerbreadth . X - Ray often record the clear picture of disruption .
indication for MRI are as follows-
Ultrasound Examination of Hand (Metacarpal Bone) and Fingers (Phalanges)
Blood Examination-
White Blood Cell Count ( WBC ) – WBC count is increase if infection is associated with disruption of metacarpal bone and phalanx .
References
1 . Ring fingerbreadth distal interphalangeal joint dislocation .
Orthop Nurs . 2013 Mar - Apr;32(2):120 - 1 .
Hart ES .
2 . PIP joint volar rotatory disruption : An anatomical bailiwick to search extensor muscle system lesions and the Stener effect .
Journé A1 , Dana C , Kilinc AS , Nourissat G , Doursounian L.
Chir Main . 2013 Jun;32(3):176 - 9 .
3 . Double dislocation of digit interphalangeal joints .
Jahangiri SA1 , Mestha atomic number 15 , McNally S.
BMJ Case Rep. 2012 Oct 22;2012 ..
4 . Complications following dislocations of the proximal interphalangeal joint .
J Bone Joint Surg Am . 2013 Jul 17;95(14):1326 - 32 .
Mangelson JJ1 , Stern P , Abzug JM , Chang J , Osterman AL .
