Finger Dislocation (Child)

A dislocation occurs when the strong bands of tissue (ligaments) that hold the bones of a finger joint together tear. This lets the bones move apart and out of place. Your child may have pain, swelling, and bruising. When a finger dislocates, a small “chip” or fracture in the bone may also occur. If the bones are only partially out of place, the injury may be called a subluxation.

When a dislocation occurs, the bones are usually put back into place (reduction). After the bones are realigned (reduced), the healthcare provider may tape the injured finger to the one next to it. This is called buddy taping. It helps keep the dislocated bones in place while the finger heals. In some cases, the finger is put into a splint. This protects the finger. The healthcare provider will tell you how long your child needs to wear the buddy tape or splint.

Most dislocations heal on their own after a reduction. This is true even for those that include a minor fracture. The healing process may take weeks to months, depending on how serious the injury is. Some dislocations do need more treatment. Some may need surgery to fix them. This is done by an orthopedic surgeon. This is a surgeon who specializes in treating bone, muscle, joint, and tendon problems.

The healthcare provider may not be able to tell right away if your child needs more treatment. That’s why it's important to follow up as directed, especially if the injury isn’t healing as expected.

In some cases, a dislocation is not able to be put back into place in the emergency department. Your child will likely need more treatment. Follow up as advised.

Home care

Follow these guidelines when caring for your child at home:

• Your child's healthcare provider may prescribe medicine for swelling and pain. Follow the provider’s instructions for giving this medicine to your child. If pain medicine was not prescribed, ask the provider what medicine to give your child for pain or discomfort. Don’t give aspirin to your child.
• Follow the provider’s instructions on how your child can use his or her affected hand.
• Keep the affected hand raised to ease pain and swelling. This is most important during the first 48 hours after the injury. Have your child sit or lie down as often as possible. Put pillows under your child’s arm so that the affected hand is raised above the level of the heart. For babies and younger children, watch that the pillows don't slip and move near the face.
• Put a cold pack on the injury to help control the swelling. You can make a cold pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the splint doesn’t get wet. You can put the pack directly on a splint. But don’t put it directly on the skin. This can damage the skin. Most children don’t like the feel of the cold. Don’t force your child to use the cold pack. Sometimes it helps to make a game of it.
• Hold the pack on the injured area for 10 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 days, and then as needed. You can place the cold pack directly on the splint. Wrap the cold pack in a thin towel.
• Make sure your child wears the buddy tape or splint until told otherwise.
• If the buddy tape gets wet or dirty, gently remove it. Retape the fingers with first aid tape. This is available in any drugstore.
• Care for a splint as you’ve been told. Don’t put any powders or lotions inside the splint. Keep your child from sticking objects into the splint. For bathing, put a plastic bag over the hand and seal it at the top with tape or a rubber band to keep the splint dry.
• If the injury includes cuts or scrapes that aren’t covered, care for these as you have been told.
• Don’t allow your child to do any activities that could reinjure the finger. This includes sports.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

Once the dislocation is healed your doctor or healthcare provider may prescribe physical therapy to strengthen and stabilize the fingers.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in newborns as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done to protect the child. Please try to be patient and not take offense.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

• Signs of infection. These include warmth, redness, or swelling, or foul-smelling drainage from a wound
• Finger of the injured hand becomes cold, blue, numb, burning, or tingly.  If the splint is on, loosen it before going for help. It may be on too tightly.
• Fussiness or crying in a baby that can’t be soothed
• Swelling or pain that gets worse. A baby who can’t yet talk may show pain with crying that can't be soothed. If the splint is on, loosen it before seeking help.
• Tingling in the finger or hand that is new or getting worse
• Fevers (see "Fever and Children" below) or chills 

© The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information has been modified by your health care provider with permission from the publisher.