We recommend that adults and children over 12 wear face masks when attending our clinic, but no longer provide masks to patients and carers. Videoconsultations are conducted via telehealth at our dedicated virtual clinic. We are experiencing high demand for appointments hence 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. If our surgeons assess that your condition (especially recent injuries) is best managed with hand therapy rather than surgery we may recommend that you see a qualified hand therapist (physiotherapist or occupational therapist) rather than schedule an appointment with our surgeons. Dr Tomlinson does not offer consultations and surgical services where a Medicare Rebatable Item Code does not apply; this includes injections for palmar hyperhidrosis. Dr Tomlinson has scheduled sabbatical leave during much of October, November and December 2023 so will not be available for urgent or emergency referrals during that time.

DIPJ dislocation

Created 18 December 2011, last modified 04 December 2012

Anatomy

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 bush A 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

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 staircase The 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.

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