The toes contain a large number of nerve endings.
When a finger is injured, an impulse instantly enters the brain; it is difficult to ignore and not notice.
Most often, toes are damaged in professional athletes or simply in lovers of outdoor games.
It is very easy to injure the fingers on the lower extremities in everyday life, due to careless movement or rapid movement. The most common diagnosis is a bruise - damage to soft tissue, skin, muscles, ligaments or tendons. But dislocation of the big toe often occurs.
The most common combined injury is bruise and dislocation. The cause is usually a blow to the finger with a heavy object or the finger hitting a hard obstacle - a stone, a wall, a step. In particular, a dislocation of the little toe, and sometimes a fracture of this finger, occurs when hitting the corner of a door, bed or threshold.
The peculiarity of such an injury is that, despite minor damage, the person instantly loses mobility. The toes are responsible for the correct distribution of loads and balance when walking. If one of them is damaged, the patient cannot move without pain and lameness.
First aid to a victim for such injuries will help to avoid complications and unpleasant consequences, quickly restore damaged tissue and restore full mobility.
The following symptoms will help you recognize a sprained ligament and a dislocated toe and not confuse it with another injury:
Symptoms with minor damage may be vague - in some cases, the patient walks with a dislocated or broken toe for several days and does not go to the emergency room until the limb begins to swell and turn blue.
The toes have strong ligaments, but are often damaged due to their location. It is possible to accurately determine whether a dislocation, fracture or sprain has occurred only with the help of x-rays or ultrasound.
If a sprain is suspected or symptoms of a sprain are observed, first aid should be provided. It is not recommended to set the finger on your own; it may be broken, and self-medication will in this case lead to bone displacement and other complications.
First aid includes the following actions:
If there are symptoms of an open fracture - a wound on the finger, bleeding, displacement of the phalanx, protruding bone or a fragment of it, you must first stop the bleeding using a pressure tourniquet, then apply a splint to the injured limb and immediately go to the doctor.
Applying ice cubes or rubbing the limb with ice is very effective for this type of injury, as it relieves swelling and thereby helps reduce pain.
But if a person suffers from diabetes, this cannot be done: blood circulation in such patients is already slow, especially in the lower extremities, and ice in this case, although it will eliminate unpleasant symptoms, can be very harmful.
It is strictly not recommended to warm your finger or use ointments and other products with a warming effect until examined by a doctor.
What is the further treatment for a finger injury?
Separate treatment is required for nails damaged by finger injuries. Often the nails become chipped or partially fall off. In this case, you need to secure the nail tightly with a bandage or plaster and wait. If it does not recover and grow in 7-10 days, it makes sense to cut it off. First aid for sprains and bruises does not always pay attention to the nail, but you should not forget about it.
There is no need to feel sorry for the nail - it will still fall off on its own after some time, but before that it will cause a lot of discomfort, inflammation or fungus may develop under it. Treating such diseases is very long and unpleasant. Therefore, it is better to solve the problem immediately - a new healthy nail will grow in a few weeks.
For the first 1-2 days, it is recommended to remain in bed so as not to put stress on the injured limb. Or at least reduce physical activity as much as possible. The leg should be kept higher than the level of the body - this will reduce blood flow to the fingers, and therefore reduce swelling and pain.
It is not recommended to unbandage and re-bandage your finger yourself, especially if a fracture or dislocation with displacement is diagnosed. In this way, the finger can be displaced; the reduction will need to be repeated, but this time the doctor may apply a plaster splint to the limb to protect the stretched ligaments and bones from further injury.
Warming up, rubbing with warming ointments and massage can be started only after the doctor’s permission, when the tissues are partially restored.
Today, a dislocated toe is a fairly rare type of injury to the musculoskeletal system. Depending on how early the dislocation was diagnosed, as well as the correct treatment, the outcome of the injury will be determined.
Today, there are two types of dislocation - in the metatarsophalangeal and interphalangeal joints. In almost all cases, there will be an indirect mechanism of injury (for example, a dislocation occurs as a result of a fall from a height onto an extended foot or due to an impact with some hard object).
If a toe is dislocated, it becomes simply impossible for the damaged toe to fully function, and a pronounced acute pain syndrome will also appear.
Also, in the area of the finger injury, hemorrhage may begin, a characteristic deformation of the injured finger will be observed, swelling and swelling will appear.
If a toe is dislocated, the patient experiences characteristic pain in the area of the injured toe; not only deformation occurs, but also movement is limited. In almost all cases, a pronounced deformity appears, as a result of which it is not difficult for a doctor to diagnose the type of injury, so a simple examination of the victim is sufficient for diagnosis.
First of all, after the formation of a dislocation, it will be necessary to ensure complete immobility of the injured limb, since there is a risk of changing the already incorrect position of the joint. That is why the victim’s leg will need to be fixed in the most comfortable position, and a fixing bandage or splint can be used. After that, ice or a simple towel is applied to the damaged area, which must be moistened with cold water in advance.
It is important to remember that it is strictly forbidden to try to straighten a dislocated toe yourself, as this should only be done by a traumatologist or surgeon. Most often, reduction will be carried out manually, and as a result of unskilled actions there is a risk of only worsening the patient’s condition, as well as significantly increasing the duration of treatment.
The diagnosis of a dislocated toe is based on anamnesis data, as well as the determination of the characteristic deformation, the position of the damaged toe itself, limitation of functions, shortening, springy immobility, and of course, the results after radiography, which is carried out without fail.
The most common dislocation of the phalanx of the first finger, most often the distal one, will be facilitated by the greatest possible freedom of movement in this joint, as well as significant functional load, which is placed directly on the first finger.
The second place in the frequency of dislocations is precisely the dislocation of the phalanx of the fourth finger. More rare are dislocations of the middle toe. First of all, this will be explained by the fact that it is the middle toe that has maximum protection due to their central location.
Quite often, victims present with dislocations of the phalanges of the toes to the sides and to the rear. Dislocations directly to the plantar side are extremely rare, which becomes possible as a result of a fairly powerful ligamentous-bursa apparatus of the plantar region itself.
It is worth remembering that the reduction of a dislocated toe should be carried out before the development of soft tissue swelling begins, of course, if this is possible. It is necessary to take into account the fact that after the development of edema begins, it becomes quite difficult to reduce the dislocation of the toes, primarily this applies to the dislocation of the middle phalanx to the plantar side, as well as dislocation in the proximal interphalangeal joint.
The basis for preventing the formation of a dislocated toe is to avoid injuries that can provoke the onset of the development of this type of dislocation.
Also, in order to prevent a dislocated toe, you need to become more familiar with the reasons that can cause it.
Treatment of closed dislocation of the phalanx of the finger, in almost all cases, is carried out on an outpatient basis, which may also include trauma centers. In this case, the victim will receive the necessary first aid for this type of injury, after which the patient should be under constant supervision.
Treatment is carried out until the natural supporting function of the entire damaged area of the foot is completely restored. Only after this the patient is given discharge and permission to go to work and lead a normal lifestyle.
In the event that a closed dislocation of the phalanges of the toes has been diagnosed, there is a need for strict adherence to the following treatment methods. First of all, the damaged finger is treated with iodine tincture, and then local anesthesia is performed - 10 milliliters of a 1% novocaine solution will be injected directly into the area of the damaged finger, as well as the distal phalanx.
In the case of difficult-to-reduce dislocations, there is a need to pass a special thin wire directly through the distal phalanx. This spoke will be fixed in a small arc, and in some cases a pin can be used. Not only passing a special needle through the distal phalanx of the damaged toe, but also using a pin, is by far the simplest, but also the safest procedure, which is carried out without negative consequences.
After this, traction along the length will be carried out directly behind the damaged finger. In parallel with this, the assistant must apply countertraction to the ankle joint itself. Further, without weakening the traction along the length at all, with one hand, as well as with the thumb of the second hand, the dislocation itself will be directly reduced - pressure will be applied to the base of the most displaced phalanx in the direction that should be completely opposite to the displacement of the phalanx.
As soon as the reduction procedure itself is completed, the doctor will have to check the extension and flexion movements in the damaged finger itself, and all manipulations must be performed very carefully and accurately so as not to provoke re-formation of the dislocation.
Next, a special adhesive bandage should be applied to the reset finger and, at the end, a control radiography should be performed. Using the above techniques, there is a chance to reduce even those dislocations that occurred more than two weeks ago.
There are cases when wires will be inserted transarticularly. After this, the damaged phalanx should be bandaged with an adhesive plaster, which is applied in several layers at once. These manipulations will be quite sufficient for further immobilization. Approximately on the second or third day, the bandage may loosen, as a result of which it will need to be re-strengthened with an adhesive plaster.
It is thanks to the use of an adhesive patch that there is an excellent opportunity, from the first days after injury, to carry out active movements directly in the joint area of the injured finger, while this process will also have a positive effect on its basic functions, which will gradually be restored.
In the event that multiple dislocations of the phalanges of the toes occur, and they are combined with the formation of fractures, then immobilization will be carried out using a plaster cast, like a boot, and the period of immobilization itself will directly depend on the number of dislocated toes (in on average from one to three weeks).
Full restoration of ability to work occurs approximately in the third or fourth week, after the procedure for reducing the dislocation.
In case of chronic dislocation of a finger, there is a need for immediate surgical intervention. In case of surgery, after approximately two or three weeks, the required range of motion in the area of the damaged joint is restored satisfactorily.
If too much time has passed since the injury, then even open reduction of the dislocation will not always give a positive result. In such cases, there is a need to perform resection of the base of the proximal phalanx.
In this case, in the future, special skeletal traction will be applied using a splint in order to correct the contraction of the soft tissues, as well as to create the correct diastasis between the head of the metatarsal bone and the resected part of the base of the phalanx, and the correct position of the damaged finger is restored.
Today, one of the most effective and common methods of treating a dislocated toe is conservative. After the reduction of the dislocation is completed, with the help of an adhesive bandage it becomes possible to obtain favorable not only functional but also anatomical results.
All patients who have had unsuccessful closed reduction, as well as in the presence of chronic dislocations of the phalanges of the toes, are prescribed surgical treatment.
A sprained toe is uncommon. This is due to fairly strong muscles and ligaments of the foot. But sometimes a slight blow is enough to cause such an injury. In this case, it is important to know how to accurately diagnose a dislocation and what measures need to be taken.
Dislocation is a displacement of the joint surfaces relative to each other. Since a large number of nerve endings pass through the fingers, their injuries are quite painful. The damage is accompanied by rupture of the ligaments and joint capsule.
The most common condition is a dislocated thumb. This is due to its extreme location and weakened ligaments. When the phalanx bends excessively, damage occurs.
The second most popular is dislocation of the little toe. The problem lies in too weak foot muscles in this area . Any blow or unnatural position of the finger will cause damage.
For proper treatment, it is important to distinguish a dislocation from a simple bruise. During a bruise, only soft tissues are damaged. Most often, such damage occurs simultaneously.
Dislocations can be divided into groups based on various factors. If we consider the time that has passed since the injury, the following injuries are distinguished:
This classification is valid only for traumatic dislocations. In some cases, the cause of the damage is a specific disease. In this case, the damage is called pathological.
Depending on the direction and location of application of the damaging force, dislocations are distinguished:
The exact direction in which the joint has shifted is usually visible to the naked eye.
Based on the degree of severity, the following are distinguished:
Depending on the type of injury, treatment and rehabilitation period will take different times.
Most often, joint dislocation occurs due to injury. Among the most common situations are:
The risk group includes not only athletes, but also children who love active games. Therefore, it is extremely important to choose comfortable shoes for children.
The main symptom that allows you to recognize a dislocated joint is severe pain in the injured area. With the help of nerve endings, a signal about an incident is transmitted to the brain. Signs of dislocation are not long in coming. At the same time, the finger itself takes on an unnatural shape and begins to turn red.
Other characteristic symptoms include:
As soon as you notice such symptoms, contact a traumatologist. Only a specialist can accurately determine the diagnosis and extent of damage.
If you don't know how to tell if you have a sprain, see your doctor. Only after a medical examination will a specialist be able to exclude the possibility of a fracture and prescribe adequate treatment.
The simplest and most common diagnostic method is radiography. Pictures are taken in two projections: lateral and frontal. If complications are detected, additional images may be needed.
Among other methods, the following are used to determine the nature of the damage:
The choice of a specific technique depends on the patient’s health condition and the equipment available to the medical institution.
In order to alleviate the condition of the victim, it is necessary to provide him with first aid. In this case, you need to follow a certain sequence of actions:
You should not self-medicate. After first aid is provided, the victim must be taken to the emergency room. The specialist will tell you what to do next. This will avoid possible complications.
Treatment of a dislocation will consist of several main stages:
It is impossible to remove the bandage ahead of schedule, as this can lead to repeated damage to the fragile joint.
After the bandage is removed, a period of rehabilitation will be required. It includes physical therapy and massage. Such procedures will help to fully restore the functionality of the finger and return to a full life.
If the dislocation is old, then it is impossible to restore the mobility of the finger without surgical intervention. After surgery, cure occurs no earlier than three weeks.
The doctor reduces the dislocated joint in an open way, that is, after cutting the soft tissue. Small metal knitting needles are used for fixation. If the dislocation is very old, resection of the proximal phalanx may be necessary.
After this, a skeletal traction procedure is performed..
After the operation, a special splint is applied to the injured finger. It will help ensure the correct position of the joint.
The rehabilitation period will require mandatory completion of a course of physiotherapeutic procedures, therapeutic exercises and massage.
Simple traditional medicine will help restore the functionality of a damaged finger faster. Among the most popular recipes are the following:
Such simple recipes will quickly and effectively eliminate the consequences of a dislocation.
In order to avoid dislocations, precautions must be taken. Try to avoid traumatic situations, follow safety precautions when playing sports. If your professional activity involves increased stress on your feet, wear special safety shoes .
Try to train your foot muscles. If they are always in good shape, the likelihood of dislocation will decrease.
A dislocated toe does not pose a particular threat to human life and health, but it certainly needs to be treated. It is better to entrust this process to professionals.
A disruption of the correct structure of a joint due to any impact is called a dislocation. The disease occurs in the joints of the upper and lower extremities.
A dislocated toe is not a common occurrence, since the foot has a well-developed ligamentous apparatus. But the consequences of injury lead to a deterioration in a person’s quality of life; it becomes difficult for him to move until the symptoms completely disappear.
Causes of the disease:
It is customary to divide injuries according to several factors:
Also, finger dislocations can be habitual, occurring several times in the same place, or pathological, associated with the addition of a disease.
Symptoms of dislocated toes are characterized by:
A dislocated big toe is characterized by severe pain, displacement of the phalanx to the side, rupture of ligaments and damage to soft tissues. A hematoma and swelling form at the site of injury, finger movement is difficult or absent.
Dislocation of the little toe is a fairly rare occurrence and occurs as a result of a blow to a blunt object. Symptoms are accompanied by moderate pain and the inability to straighten or bend the finger. Sometimes there is pallor of the skin and numbness in the injured area.
Includes a sequence of actions:
You should not try to treat the joint yourself. These actions can cause even more harm and lead to the development of complications or painful shock.
Diagnosis of the location of the injury is carried out by a doctor to make a more accurate diagnosis and choose treatment tactics.
The examination is carried out using several methods:
Treatment for a dislocated toe involves several steps.
Correction of abnormal joint position is performed in a hospital setting under local anesthesia. The doctor adjusts the dislocation under X-ray control using pressure until the joint capsule returns to its original shape.
In case of severe injuries or old injuries, a pin is inserted through the distal phalanx, which extends the damaged finger.
After completion of the procedure, a bandage of adhesive plaster or plaster is applied to the injury site. In case of multiple dislocations or combined injuries, the leg is subjected to special plaster immobilization for up to 3 weeks.
To reduce symptoms after dislocated fingers, medications are used. This measure is temporary, as it is aimed at reducing swelling and preventing the development of inflammation.
NSAIDs, which effectively relieve pain, and muscle relaxants, which are used to relieve muscle tension, are often prescribed.
If there is a high risk of side effects, the doctor may prescribe local remedies in the form of an ointment or gel.
You cannot take medications on your own, as this can lead to complications or allergic reactions.
Treatment of chronic dislocations is carried out surgically. It allows you to restore the anatomically correct shape of the joint and the functionality of the foot when walking and putting pressure on it.
Often an open reduction of the joint is performed, fixing them with special knitting needles. Sometimes resection of the proximal phalanx is performed followed by traction.
Exercises are necessary during the rehabilitation process after closed reduction and surgery.
To prevent muscle atrophy and restore the motor ability of the fingers and feet, a course of special classes has been developed:
Gymnastics should be done daily, performing each approach at least 10 times. If pain occurs, you should postpone exercise until the symptoms are completely eliminated.
Alternative medicine techniques cannot help correct a dislocation, but are effective in relieving discomfort after injury and reducing the risk of complications.
After removing the plaster cast and surgery, the patient is prescribed a course of rehabilitation measures, which include:
For the first time after removing the cast, you should not carry heavy objects, put any weight on your leg, or walk in narrow, uncomfortable shoes.
In advanced cases, failure to contact a specialist in a timely manner may result in the following consequences:
A sprained toe is an ailment that should not be ignored. To avoid the development of complications, you must consult a doctor and follow the prescribed prescriptions.
In everyday life, quite often you have to deal with various injuries when the lower extremities suffer. And among the injuries to the musculoskeletal system, it is quite possible to encounter displacement of the articular surfaces, that is, dislocations. And although they are less common for the toes than other types of injuries, they are still associated with obvious physical suffering and functional limitations.
Dislocation of the toes occurs when they are exposed to a strong mechanical factor. Despite the ligamentous apparatus, and sometimes even with its damage, the articular surfaces occupy an incorrect position relative to each other. This is observed in two main cases:
The indirect mechanism of injury is of decisive importance, since it is in the situations described that the maximum displacement of the phalangeal joints relative to the tarsal bones is observed. But direct blows to the foot do not have a similar result. As a rule, dislocated toes are observed in athletes (usually football players), as well as in everyday life among people leading an active lifestyle. Injuries due to accidents at work or during road traffic accidents cannot be ruled out.
Establishing the mechanism of injury is an important component of diagnosis, helping to determine the type of injury and appropriate measures to eliminate it.
Clinically, foot dislocations have a common classification with similar injuries of other locations. First of all, displacements can be complete or incomplete. Based on the time that has passed since the injury, they can be characterized as:
If the joints are displaced due to some disease, then they speak of a pathological rather than traumatic dislocation. More specific moments are associated with local features of the foot. Depending on the direction in which the force was applied, the following types of dislocations are distinguished:
Even with the naked eye you can determine in which direction relative to the foot the toes are moving: up, down or to the side. Moreover, they dislocate less frequently towards the plantar part of the foot, which is due to the powerful ligamentous apparatus in this area. In addition, injuries to the phalanx (distal, middle) or metatarsophalangeal joints are distinguished. Multiple displacements of the articular surfaces also occur, which are often associated with fractures of the bones of the foot, trauma to blood vessels and nerves.
According to the classification, toe dislocations have much in common with other similar injuries, but their characteristics are more important for diagnosis.
Each injury is characterized by certain characteristics. Sprained toes are no exception. It should be noted that such damage has both specific and nonspecific features. The first of them include the following:
If we consider the general signs of a dislocation, we must remember that they are typical for most types of injuries. Such symptoms are a nonspecific tissue response to damage and include:
It is clear that a dislocated toe significantly limits walking, not to mention more active actions of the lower extremities. Patients are unable to carry out their professional responsibilities and daily activities. Painful sensations can provoke disturbances in the emotional sphere: irritability, insomnia, decreased mood.
Symptoms of dislocations in the foot area are quite typical. Therefore, the diagnosis can be established even on the basis of a clinical examination.
Most often, patients experience a dislocated big toe. This is due to its location and the significant load falling on the anterior inner edge of the foot. Basically, we have to note damage to the distal phalanx, which moves upward or to the side. And this, in turn, is accompanied by a rupture of the plantar or lateral ligaments, respectively.
A dislocation can be complex when the articular surface moves upward, but the thumb remains in the same position, that is, oriented forward. In this case, the proximal phalanx may become caught on the edge of the first metatarsal bone. In addition, the sesamoid bones, located deep in the flexor tendon, are often pinched between the articular surfaces, which complicates the reduction of the displacement.
In contrast to damage to the big toe, dislocation of the little toe is quite rare. This type of injury occurs when there is a fairly strong blow to the outer edge of the foot. This causes the finger to move upward or inward. Considering the size of the little finger, the metatarsophalangeal joint is susceptible to dislocation, as it is the largest and most mobile.
It is not uncommon to observe displacement of the fourth toe. It is higher than the little toe, and therefore is more susceptible to dislocations when the foot is exposed to a traumatic factor. Isolated displacement of the middle fingers occurs much less frequently, which is due to their central position, and, therefore, greater security. We are talking about such an injury when there are multiple injuries, when several toes are affected.
The first toe is dislocated much more often than the others, accompanied by the most severe symptoms.
To confirm a sprained toe, the patient must undergo additional testing. It includes imaging diagnostic methods that allow you to see the discrepancy in the location of the articular surfaces. Such means include:
As a rule, this is enough to make a diagnosis. And after a clinical examination and receipt of examination results, the traumatologist decides how to treat the dislocation.
Diagnostic measures include instruments that allow you to take a picture of the injured toe and see the displacement of the articular surfaces.
Dislocations, like other injuries, require timely treatment, which requires a competent approach to their reduction. All features of the injury must be taken into account, so there is no single scheme, but only an individual program for each patient. It includes the following components:
These are the basic methods used to treat dislocated toes, and restorative treatment may also include physical therapy, massage, and exercises aimed at preventing re-dislocations.
Immediately after injury, the patient experiences acute symptoms that need to be relieved. For this, as well as in order to improve the condition of damaged tissues, certain measures are taken, included in the first aid program. These include the following:
After this, you need to contact the nearest medical facility to provide qualified medical care. Next, a specialist will treat the dislocation.
First aid measures are designed to reduce the patient's suffering and minimize the consequences of injury. This improves the results of further treatment.
The basis of treatment for dislocations is their reduction. The manipulation is carried out in trauma centers or other outpatient facilities. Manual reduction for fresh dislocations is not difficult. It is performed after numbing the finger with Novocaine solution. If the dislocation is not fresh, then a special pin is passed through the distal phalanx, through which traction (extension) is applied along the length of the finger, pressing on the displaced area until the joint is in place.
After reduction, immobilization of the finger is necessary. It is mainly performed using an adhesive bandage. But in case of multiple dislocations, it is necessary to apply a “boot” type plaster cast. The duration of fixation varies from 1 to 3 weeks, depending on the number of dislocated fingers.
To reduce the symptoms of dislocated fingers and facilitate reduction, medications are used. But such treatment is temporary. Non-steroidal anti-inflammatory drugs that have an analgesic effect (for example, Ortofen, Movalis), as well as muscle relaxants necessary to reduce reflex muscle spasms (Mydocalm, Tolisor) are mainly used. After reduction, you can use local forms of medications: ointment, gel, cream.
Drug treatment is carried out only as prescribed by a doctor and under his supervision. You cannot take any medications on your own.
Old dislocations most often have to be treated surgically. This allows you to restore the anatomical relationships in the foot and the function of the toes. But if the injury is quite old, even surgery may not give a clear result.
Basically, open reduction of the joints is performed, fixing them in the achieved position using knitting needles. For long-standing dislocations, it is necessary to perform resection of the proximal phalanx followed by skeletal traction. Rehabilitation treatment necessarily includes gymnastics, massage, and physiotherapy.
Thus, sprained toes are a problem that almost anyone can face. Much will depend on the timeliness of seeing a doctor, since it is much easier to treat the consequences of an injury that has occurred recently. And the effect of therapy in this case will be much higher.
A short-acting injury is sufficient to cause a dislocation in any joint of a finger or toe. But the injury must be of significant intensity so that it can stretch the ligaments and capsule.
As a result of such a situation, a dislocation of any finger occurs, which can be open or closed. Perhaps the cause will be a blow to the joint, as well as a fall on an outstretched arm.
Dislocation is possible, which can occur with sudden or violent movement.
On the foot, this kind of situation occurs when a person trips, for example, on a carpet on the floor or a step. This often leads to damage to the thumb, but this does not mean that the rest are not insured.
In this case, the main condition should be the absence of shoes or open toes; if they are closed, then subluxation or fracture is possible.
Most often, a dislocated toe occurs as a result of a blow to the fingers or foot, and in most cases, athletes face this type of injury.
Dislocations of the big toe are more common than others, but according to medical statistics, they account for only about 2% of the total number of patient visits to traumatologists with any kind of dislocation.
The big toe is injured more often than others because its location is somewhat specific, it is much larger than the others, it always protrudes forward, and therefore is the first to take any blow.
All dislocations are divided into traumatic (resulting from force on the foot) and pathological (displacement of the joints occurred due to the development of a disease). Traumatic finger dislocation can occur at the interphalangeal or metatarsophalangeal joint.
According to the general classification, a dislocation of a toe can be complete (when the articular surfaces are completely displaced) and incomplete (when the surfaces are in contact).
Also, dislocations can be open (if there is a wound) or closed (if there is none). Based on the time that has passed since the injury, a dislocated toe is characterized as:
Depending on the direction of the applied force, dislocations can also be divided into dorsal, plantar and lateral. The direction is easy to determine visually by the direction in which the fingers move. Each case has its own symptoms and requires an individual approach to treatment.
Any toe can potentially be dislocated, but the most common injuries occur in the big toe or little toe area. Displacement of the ring, second and middle fingers occurs much less frequently, due to their position.
More often than others, in traumatological practice we have to deal with dislocations of the big toe. The reason for frequent injuries is the significant load placed on the inner edge of the foot.
The distal phalanx is mainly damaged, the injury of which leads to rupture of the plantar and lateral ligaments. The medical literature describes in detail a complex case of dislocation of the thumb, when its position remains oriented forward, and the articular surface moves upward.
The complexity of this case is associated with the possibility of entangling the proximal phalanx of the big toe on the edge of the metatarsal bone. Another possible complication is clamping of the sesamoid bones in the thickness of the tendon. The presence of such injuries can significantly complicate the reduction of the dislocation.
Unlike the big toe, a dislocation of the little toe is much less common and occurs when there is a significant impact with the outer edge of the foot. The displacement occurs in the upper or internal direction. With this injury, dislocation of the largest and most mobile metatarsophalangeal joint is most often observed.
Appearance of dislocation
Dislocation can be complete when the articular surfaces are completely displaced. Incomplete dislocation is observed when there is contact of the articular surfaces with each other.
With a fracture-dislocation, there is a violation of the integrity of the bones of the little finger. And in relation to the environment - open (there is a wound) or closed (the skin over the site of dislocation is not damaged).
Each option requires its own approach to diagnosis and treatment and has its own symptoms.
Experts classify all dislocations of fingers and toes into the following subtypes:
Dislocations can also be divided into habitual, that is, when a finger on a limb is injured several times in a row in the same place, as well as intra-articular and periarticular (they are more severe and dangerous).
Most often, dislocation of the thumb and index finger occurs, with the little finger in second place. It is quite easy to damage, both on the foot and on the forelimbs.
When a toe is dislocated, the following symptoms are observed:
If you suspect a dislocated toe, you should seek medical help as soon as possible, where a diagnosis will be made and treatment will be prescribed.
When a finger on a limb is injured, the victim exhibits the following symptoms of dislocation:
Subcutaneous hematomas during dislocation
If in the case of the reasons everything is at least a little clear, then recognizing a dislocation, especially if it is incomplete, can sometimes be difficult. When a dislocation occurs after an injury, severe and intense pain develops, which prevents the person from moving the injured toe normally or stepping on the foot normally.
The finger itself is deformed and swollen compared to a healthy one, and there may be a subcutaneous hematoma.
The big toe is most often injured. When a toe is dislocated, symptoms appear almost immediately:
There are characteristic signs that will indicate that a dislocation has occurred. But a condition such as subluxation often occurs, when the displacement of the articular surfaces does not occur completely.
Very often, dislocation occurs in the area of the big toe, since on the hand it is moved to the side, but on the leg it is most massive.
When a dislocation occurs, the first thing to do is limit the functionality of the damaged joint, and sometimes even part of the foot. A person experiences acute pain almost immediately after the blow, but it intensifies significantly when trying to step on his foot or move his fingers.
Movements are immediately limited. Any movement of the finger during a dislocation causes unbearable pain. In this case, the damaged toe is always deformed, which gives the foot an unnatural appearance.
Gradually, a hematoma appears at the site of injury, which can cover the entire surface of the finger and surrounding tissues. But puffiness, like swelling, appears very quickly if measures are not taken immediately.
When a finger is dislocated, swelling can spread to the entire surface of the foot, which will significantly complicate the injury's reduction and treatment.
When visiting the emergency room to confirm a dislocated toe, the doctor will conduct a visual examination to determine whether the location of the articular surface of the toe in relation to the rest of the surrounding toes is inappropriate.
Next, the traumatologist will issue a referral for radiography, MRI, and ultrasound in order to make an accurate diagnosis and, based on the images obtained, will develop an individual approach to treatment in case of severe displacement of the composite surface.
A simple examination is not enough to diagnose a dislocation; additional methods are needed. The simplest and most common is x-ray, which is performed in two projections.
When a finger is dislocated, it becomes severely deformed and often takes on an unnatural position, so a doctor can easily diagnose an injury only by the presence of external signs and a study of the medical history.
But to determine the characteristics of the damage, an x-ray examination will be required. When the phalanx of the thumb is dislocated, the distal part is most often damaged, since it is here that the joint has the greatest mobility and the maximum level of load also occurs here.
In second place among toe dislocations in terms of frequency of diagnosis is damage to the fourth toe, or more precisely its phalanx.
The middle toe is extremely rarely dislocated, even when seriously injured, because due to its central position it is quite well protected.
When carrying out diagnostics, a displacement of the damaged fingers to the outside or back is often detected. Dislocations towards the sole occur only in isolated cases, since their occurrence is possible only with the special structure of the foot and ligamentous apparatus.
Reduction for a dislocated little finger
Treatment for a dislocated finger is conservative; under local anesthesia, the doctor will straighten it and then fix it with a plaster splint. You can simply attach the injured finger to the healthy one next to it using a regular bandage.
If a cast is applied to the injured toe, you can walk, but only with support on your heel. And if immobilization was carried out using a bandage, then you need to walk in shoes with a thick insole.
You can make such an insole using cardboard or thick felt. The finger is not a supporting one, so you shouldn’t expect any problems from an injury.
The ligamentous apparatus must become stronger, so the immobilization will have to be worn for about 2-3 weeks, after which it will be removed and you can walk normally and fully. Tablets can help relieve the pain, but injections, which are often injected into the muscle, can also be used.
Gels and ointments are applied topically to reduce swelling and pain. Physiotherapy is also indicated.
The most commonly used are UHF, magnet, etc.
After a dislocation, repeated injuries must be avoided for 6 months, otherwise the dislocation may recur.
For any injury to the little finger, you should not self-medicate, but rather consult a doctor. The sooner this is done, the more successful the reduction will be.
There are practically no muscles and tendons in this area, so there is no fear of tissue getting between the bones. The main thing is not to delay, even if at first glance there is nothing.
Only an x-ray can give you confidence that everything is normal.
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The main treatment for joint dislocations on the leg is carried out only in outpatient settings. It is prescribed only by a doctor and only after additional examination and x-rays.
In the closed type, the injury site is treated with iodine tincture and local anesthesia is administered. After this, the joint is set into place.
If the injury is difficult to reduce, then in this situation the doctor uses a special thin needle. This is not a complicated and quite simple procedure.
After repositioning the injured joint of the phalanx of the foot into place, control movements of flexion and extension are carried out. Be sure to take a control x-ray and apply an adhesive bandage.
This bandage weakens on the 2nd or 3rd day and should be re-strengthened with a new layer of adhesive tape. Such treatment can be carried out if the dislocation of the phalanx joint on the leg occurred no more than two weeks ago.
An adhesive plaster bandage makes it possible to resume active movements of the injured limb from the first days.
If not one, but several joints of the phalanges of the foot are dislocated on the leg, which are accompanied by bone fractures, then in this case fixation occurs using a plaster cast of the “boot” type. A similar bandage is applied for a period of 1 to 3 weeks, depending on the number of dislocations.
Treatment of such chronic injuries involves surgery in most cases. In this case, the ability to move more or less normally appears after 2 or 3 weeks.
But not in all cases, surgery can solve the problem. If the injury is too old, then after the operation a special splint is applied to create the necessary diastasis to ensure the correct position of the finger in the future.
Once a person is taken to a medical facility, a sprained toe or hand may be corrected. Only a doctor has the right to do this after an examination has been completed, all symptoms have been taken into account, and an image has been taken.
Everything is done under local or regional anesthesia, the subluxation of the joint or its displacement is eliminated. Then a cast is applied in the correct position; it must cover at least two joints, including the ankle or wrist.
It is mandatory to take a control shot, which will show whether the finger is back in place or not.
Additionally, drug treatment can help eliminate residual symptoms. Non-steroidal anti-inflammatory drugs are prescribed for pain relief.
Since it is necessary to treat swelling, there is a special group of drugs for this. Special preparations – chondroprotectors – also help restore joint cartilage.
Special painkillers and anti-inflammatory ointments are successfully used. They complement the treatment of damage and help reduce swelling and pain.
It is necessary to treat a dislocation using immobilization for an average of 2 to 4 weeks until the capsule and ligamentous apparatus are completely restored. If there is a subluxation, then it needs to be treated for a slightly shorter period of time.
Then special gymnastics are prescribed to completely eliminate the symptoms. It should be done on the recommendation of a doctor as he recommended.
There is a specific treatment in a situation where the dislocation is old. The same can be a subluxation resulting from incomplete treatment or early removal of the cast.
Chronic dislocation of any finger or toe can only be treated surgically. The main thing is to eliminate the damage as soon as possible after the injury, then the treatment will have maximum success.
In a situation where emergency medical care is unavailable for some reason, a victim experiencing acute symptoms must be provided with first aid, including:
In the process of providing first aid, the primary task is to limit the flow of blood to the site of injury. The exception is when the victim suffers from diabetes.
In such a situation, a sharp decrease in blood flow can be dangerous, so this must be done naturally by lifting the leg up while bandaging.
In case of a dislocation, it is better to immediately go to the nearest emergency room. The painful symptoms can be so unbearable that they hinder movement and make it impossible to step on the leg.
As first aid you need:
There are signs by which you can recognize a dislocated toe. Common symptoms include the following:
Dislocation of the big toe is more common than the other toes (although the strength of its muscular system is higher).
To be completely sure of the diagnosis, it is recommended to take an x-ray at a medical facility.
If you identify the first signs of an injury, you need to provide first aid to the injured finger.
First aid involves removing the load from the injured area. The victim must be taken to a medical facility to provide qualified assistance. If this is not possible, an ambulance should be called to take him there.
If the bones of the phalanx are displaced, it is recommended to set it in place, as this can prevent swelling or swelling. This dislocation of the phalanx is always accompanied by pain, and to eliminate or relieve the pain it is necessary to apply something cold to the leg, for example, a cold compress.
It is better to keep the leg in an elevated position, which will reduce blood flow to the sore spot.
When a little finger is dislocated, it is important to provide first aid, which will help reduce pain and get to a medical facility normally. Cold is applied to the injured finger.
You can take painkillers and then not fix the toe, but get to the hospital by stepping on the heel. There will be no pain during this movement, due to the lack of support on the finger.
A dislocated finger can occur at any time. Therefore, it is important to know what exactly needs to be done in case of a dislocation, and how to provide first aid correctly.
First of all, you need to call a doctor or take the injured person to the hospital. If the bones of the phalanges of the toe are displaced, it is advisable to set the injured joint back in place before a tumor forms.
Dislocation of the joint of the phalanx of the foot is always accompanied by severe pain. To relieve pain, apply a cold compress or ice to this area.
Also, when providing first aid to a victim, your leg should be placed on a raised platform. This will reduce blood flow to the limb.
You should not heat the injured area - such measures will only aggravate the swelling. But cold compresses and ice cannot be used if the injured person has diabetes.
Cold reduces blood flow to the limb, and in case of diabetes this is extremely undesirable.
Dislocation of the big toe is more common than similar injuries to other fingers of the lower extremity. This predisposition to injury is due to the specifics of its location.
Isolated cases include dislocation of the little finger. But it is this damage that requires special attention.
In this case, you should not take independent action, but immediately contact a specialist. The only thing that can be done is to apply a tight bandage to the entire foot and take the victim to the nearest hospital or trauma center.
It is important to remember that you are only allowed to correct an injury yourself in an emergency, when it is not possible to get help from a qualified specialist within the next 2 hours after receiving the injury.
In all other cases, self-reduction is strictly prohibited, since with any careless or incorrect movement a person may remain disabled and forever lose the ability to move normally.
It is very important to take the patient to the hospital within the first hour after the injury, before swelling begins to form at the site of injury, which will significantly complicate reduction.
To prevent the formation of edema and swelling, it is necessary to apply ice to the site of dislocation immediately after injury. Cold will not only reduce the likelihood of swelling, but also ease the pain, because such a dislocation is always accompanied by very sharp and severe pain.
It is important that the victim's leg is elevated to reduce blood flow to the injured limb.
It will not be possible to effectively treat a dislocation if you do not use physiotherapy. The doctor has many techniques in his arsenal that will allow him to treat the injury as soon as possible after the injury. The list can be presented like this:
Thermal procedures allow you to restore normal blood flow and accelerate the healing of joint tissue. The person returns to duty as quickly as possible; the load on the injured finger should not be placed immediately. This is done gradually, the tissues should regenerate well.
It is important to go to the hospital as soon as possible, because treatment of old dislocations is problematic and not always effective. In addition, often the symptoms of a dislocation may hide a fracture, the absence of treatment of which can lead to unpleasant consequences, including limitation of the functioning of the foot.
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Possible complications include the following:
The duration of rehabilitation after such a dislocation largely depends on the timeliness of the reduction, the complexity of the injury, as well as on compliance with all doctor’s instructions during treatment.
On average, recovery time can range from 3–4 weeks to several months, if surgery was required to reduce a dislocation (for example, an old one).