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Choice of Treatment for Dislocation of Hand, Thumb and Fingers
1. Conservative Treatment for Dislocation of Hand, Thumb and Fingers
a. Restriction of Hand And Finger Movement1–
Restriction is advised after reduction of dislocation to immobilize the articulation . Joint restriction is reach with follow methods-
Advantages of Cast-
Disadvantages of Cast-
b. Heat And Infra Red Therapy for Dislocation of Hand, Thumb and Fingers
c. Daily Exercises for Dislocation of Hand, Thumb and Fingers
e. Cold Therapy for Dislocation of Hand, Thumb and Fingers
2. Medications for Dislocation of Hand, Thumb and Fingers
A. NSAIDS (Non-Steroidal Anti-inflammatory Medications) for Dislocation of Hand, Thumb and Fingers
Most coarse NSAIDs Prescribed are Motrin , Naproxen and Celebrex .
B. Opioids Therapy for Dislocation of Hand, Thumb and Fingers
indication for opioids therapy is as follows-
Opioids are order for brusque - full term nuisance relief or prolong pain relief and are categorized as :
a. Hydrocodone :
Available in anovulatory drug and known as Vicodin , Lortab and Norco .
Vicodin – Hydrocodone of quantity 5 mg , 7.5 mg and 10 mg is flux with 650 mg of Tylenol .
Daily Dosage- 15 to 60 mg of hydrocodone .
Lortab – Hydrocodone of quantity 5 mg , 7.5 mg and 10 mg is mixed with 500 atomic number 12 of Tylenol .
Norco – Hydrocodone of quantity 5 mg , 7.5 mg and 10 mg is sundry with 350 mg of Tylenol .
Norco is preferred if gamey dose like 30 to 60 mg of hydrocodone is prescribed for pain discussion so Tylenol dosage is stay fresh below 2 gm .
b. Oxycodone-
Available in tablet form roll in the hay as Oxy IR and percocet
c. Morphine-
Oxycodone- Oxycontin
Morphine- MS Contin
Methadone
C. Muscle Relaxants for Dislocation of Hand, Thumb and Fingers
Muscle relaxants are prescribed for muscle spasm and joint stiffness
Baclofen
cyclobenzaprine
Skelaxin
Robaxin
3. Physical Therapy (PT) For Dislocation of Hand, Thumb and Fingers
Goal of Physical Therapy (PT)
Techniques of Physical Therapy (PT)
4. Interventional Pain Therapy for Dislocation of Hand, Thumb and Fingers
Interventional pain therapy is rarely indicated following intervention of dislocation of hired hand and fingers . Interventional painful sensation therapy admit injection of corticosteroid or local anesthesia in the stick .
Cortisone Injection for Dislocation of Hand, Thumb and Fingers
Cortisone injection is do to quash inflammation follow close diminution if nuisance stay .
Severe pain if not responding to nonsteroidal anti-inflammatory and opioids , then the inveterate pain is treat with frequent cortisone injections . Injections are repeated between 3 to 6 months .
Local Anesthetic Injection for Dislocation of Hand, Thumb and Fingers
Therapeutic note value of just local anaesthetic injection is very limited .
When to Avoid Interventional Pain Therapy or Injections-
5. Close Reduction for Dislocation of Hand, Thumb and Fingers
Close reducing is performed in physician spot or ER.2
Indications for Close Reduction To Treat Dislocation of Hand, Thumb, and Fingers-
6. Surgery for Dislocation of Hand, Thumb and Fingers
Metacarpophalangeal Joint ( Knuckle Joint ) Dislocation-
Internal Fixation (Plate and Screws)3for Dislocation of Hand, Thumb and Fingers
Arthrodesis of MP and IP Joint4for Dislocation of Hand, Thumb and Fingers
The gentle tissue over the joint are tailor back together . The forearm and mitt are then placed in a cast until the os altogether fuse together . This withdraw about six weeks .
Arthritis-
Joint Infection or Septic Arthritis-
Deformity-
Healing of joint breakdown may be affiliate with visible and tangible misshapenness .
reference
1 . Treatment of PIP joint dislocation
McDevitt ER .. Phys Sportsmed . 1998;26:85–6 .
2 . Am Fam Physician . 2013 Feb 1;87(3):160 - 2 .
right technique for reduction of metacarpophalangeal dislocation .
Gammons M.
3.Opened dorsal metacarpophalangeal dislocation of the four long fingers . palmar plates reinsertion with anchors .
Uhring J1 , Gallinet D , Gasse N , Obert L. , Chir Main . 2012 Jun;31(3):163 - 5 .
4 . condensation arthrodesis of digit joint .
Leonard MH , Capen DA .
Clin Orthop Relat Res . 1979 Nov - Dec;(145):193 - 8 .
