Hand injuries are commonly seen in the emergency department (ED), and emergency physicians should be able to identify and provide emergent management of digital dislocations. Complications can occur if the diagnosis is missed or delayed or if the joint is incompletely reduced or improperly splinted.
Every emergency physician should have a firm understanding of the acute management of simple dislocations of the digits. Historical, physical, and radiographic findings often guide the management of the dislocation. When the dislocation is complicated, consult with and/or refer to a hand surgeon. Generally, reduced dislocations without evidence of instability and near-normal range of motion can be treated with brief immobilization and subsequent referral.
For patients with a hand dislocation who are being transported by emergency medical services (EMS), immobilization of the deformed joint, protection of soft tissue injury, and provision of pain relief are the mainstays of prehospital treatment.