page_title: Jammed finger
section_title: Elevation
hierarchical_section_title: Jammed finger / Treatment / Elevation
caption_attribution_description: English: Joint dislocation DIP of D2. Deutsch: Luxation des DIP des Zeigefingers.
context_page_description: Jammed finger is a colloquialism referring to a variety of injuries to the joints of the fingers, resulting from axial loading beyond that which the ligaments can withstand. Common parts of the finger susceptible to this type of injury are ligaments, joints, and bones. The severity of the damage to the finger increases with the magnitude of the force exerted by the external object on the fingertip. Toes may become jammed as well, with similar results.
context_section_description: Finally, elevation of the affected area above the heart reduces the blood flow to the injured region due to the difference in hydrostatic pressure between the finger and the heart. This has similar effects to the first three components of the method.
  Following the implementation of this method, splinting is recommended to keep the digit immobile. The skin under the splint should be carefully observed during the duration of its use due to the number of complications that can arise, including ulceration, maceration, and tape allergy. When removing the splint to assess the skin underneath, it is important that the digit remain in the splinted position. These complications can be reduced by including a layer of tubular gauze or a moleskin lining between the splint and the skin of the finger. If no splints are easily available, buddy taping can be employed. This is where the affected digit is taped to an adjacent finger to provide support. This limiting of motion helps to reduce ligament stress, which is important in the early stages of healing. If swelling persists, anti-inflammatory medications may be prescribed.
  A third degree sprain often results in a dislocation. Volar and dorsal dislocations are treated differently, and treatment should be withheld if a fracture is suspected. In the case of a dislocation, closed reduction can be attempted. This is where the joint is realigned without the need for surgery, and can be conducted immediately after the incident. For a dorsal dislocation, reduction should be conducted by undertaking distal traction of the fingertip, then applying volar pressure to the phalanx in the distal direction of the dislocated joint, and dorsal pressure to the other phalanx. Ensure that the joint can be moved with no pain. After this, a splint at a small bend is employed to maintain slight flexion and prevent hyper-extension of the joint for the next week. If hyper-extension of the joint is too painful or causes skin blanching, the joint may be placed in a neautral position. Limited movement of the affected digit is recommended to occur soon after the injury to limit loss of range of motion. Note that this may only include small degrees of flexion, depending on the severity of the injury. For volar dislocations, reduction should be conducted by undertaking distal traction of the fingertip, then applying distal pressure to the phalanx in the distal direction of the dislocated joint, and volar pressure to the other phalanx. Unlike dorsal dislocations, after performing reduction on a volar dislocation, the joint must remain splinted at full extension. After reduction, tendons may be tested through active flexion and extension. Due to swelling and pain, a full range of motion is unlikely to occur, however if no active flexion or extension can be done, it indicates a high possibility of a tendon rupture. If no avulsion fracture is present, the splint should be in place for four to six weeks to allow the torn central slip to heal in the correct location, with an additional four to six weeks splinting during sporting activities. If there is an avulsion fracture involving more than thirty percent of joint space, an orthopedic surgeon should be consulted, as open reduction and internal fixation may be required. If the dislocation does not reduce easily, it may be necessary to administer local anaesthetic, or in extreme cases open reduction may be required. There are currently four causes of an irreducible DIP joint dislocation, brought about by an anatomic block, where there is difficulty accessing parts of the finger. These causes are: "a palmar plate avulsion off the middle phalanx with interposition in the joint, entrapment of the flexor digitorum profundus (FDP) tendon behind one condyle of the middle phalanx, button-hole tear through the palmar plate, and entrapment of the distal end of the middle phalanx in a longitudinal split in the FDP tendon". Any of these cases will require open reduction, conducted under anesthetic. Following open reduction, the joint should be immobilised for two to four weeks in a
caption: DIP Dislocation
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