Melbourne Hand Surgery 

Please note: We do our best to accommodate emergency and urgent referrals upon receipt of your doctor's referral. Dr Tomlinson is currently booked some months in advance so if your condition is urgent or you wish to be placed on our "Waiting for an Early Appointment" list to see Dr Tomlinson or Mr Babazadeh please provide us with your doctor's referral and your registration forms so that we can facilitate an urgent review. We strongly encourage individuals who are seeking non-surgical treatment of Dupuytren's contracture with Dr Tomlinson to seek placement on our waiting list and provide us with details of your availability, so that we can contact you in the event of an earlier appointment becoming available. If you have recently sustained a hand or wrist injury you may wish to explore the option of the Action Rehab Urgent Care Clinic, where your injury will be assessed and managed by an experienced hand therapist.

DIPJ dislocation

dorsalhandbonesAnatomy

The end joint of the finger is called the "distal interphalangeal joint" (abbreviated as "DIPJ"). It is the joint between the distal phalanx and the middle phalanx bones in the fingers.

Distal interphalangeal joint (DIPJ) dislocation commonly occurs from a sporting injury when there is a blow to the finger. The injury causes stretching or tearing of the ligaments, including the "volar plate" which is the ligament on the front of the joint.

Closed dislocation

hand with ring over bushA closed dislocation is when the joint is dislocated but there is no injury to the overlying skin - so the joint is not "open" to the external world. If a closed dislocation can be relocated it is not necessary to do surgery.

However, it can be difficult to achieve effective splinting of a DIPJ dislocation with a plastic splint, so in instances when this injury is associated with complete avulsion of the volar plate it may be preferable to repair the ligament surgically.

Open dislocation

dislocationDIPJfromRadiopaediaDOTorg

An "open" dislocation occurs when the force of the dislocation tears the tissues overlying the joint, resulting in a wound that allows the joint to communicate with the outside world. This carries a significant risk of infection. Antibiotics and surgical washout of the joint is recommended. At the time of the washout the surgeon will commonly repair any injured ligaments. You will be placed in a splint and commence movement exercises around a week after surgery.

Overall goal

fingers walking up book staircaseThe most important goals in treating a dislocated finger are to end up with a mobile, stable finger. You want your finger to have a full range of movement and to not be unstable in any particular direction. Achieving this requires a careful balance of stillness (splinting) and movement (finger exercises), and sometimes (but not usually) surgery.

FRACS

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