Melbourne Hand Surgery 

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Latest news: Masks are and will remain mandatory when you attend our practice in person, and we request that you log your attendance via our Victorian Government QR code, by entering location code 3D7RE3 into the Services Victoria App or by writing your details on the physical register at our reception.

Elective surgery is currently unrestricted by COVID, as are rooms procedures. Dr Tomlinson is operating at The Avenue and Glenferrie Private; Epworth Cliveden has closed. Our offices are closed on Friday.

All suitable consultations at Melbourne Hand Surgery are currently conducted via telehealth at our dedicated virtual clinic to maximise patient and staff safety. We have enhanced hygiene measures in our rooms including acrylic screens, masks, hand sanitiser, face shields and physical distancing-related changes. We require that all patients provide a referral prior to booking an appointment so that we can identify and manage urgent and emergency conditions in a timely manner, and so that our surgeons can assess your suitability for a telehealth appointment and identify any further information or tests that might be required before your consultation.

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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