Dislocated Finger (Child)
A dislocation happens 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 happen. If the bones are only partially out of place, the injury may be called a subluxation.
When a dislocation happens, the bones are usually put back into place (reduction). After the bones are realigned (reduced), the doctor 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 doctor 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 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 doctor 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:
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Your child's doctor may prescribe medicine for swelling and pain. Follow the doctor’s instructions for giving this medicine to your child. If pain medicine was not prescribed, ask the doctor what medicine to give your child for pain or discomfort. Do not give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.
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Follow the doctor’s instructions on how your child can use their affected hand.
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Keep the affected hand raised to ease pain and swelling. 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.
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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.
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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 or wrap the cold pack in a thin towel.
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Make sure your child wears the buddy tape or splint until told otherwise.
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If the buddy tape gets wet or dirty, gently remove it. Retape the fingers with first aid tape. This is available in any drugstore.
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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.
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If the injury includes cuts or scrapes that aren’t covered, care for these as you have been told.
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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 doctor as advised.
Special note to parents
Doctors are trained to recognize injuries like this one in children as a sign of possible abuse. Several doctors may ask questions about how your child was injured. Doctors must, by law, ask you these questions. This is done to protect the child. Please try to be patient and not take offense.
When to contact your child's doctor
Contact your child’s doctor right away if:
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Your child has signs of infection. These include warmth, redness, swelling, or bad-smelling fluid leaking from a wound.
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The finger of the injured hand becomes cold, blue, numb, burning, or tingly. If the splint is on, make it looser before going for help. It may be on too tightly.
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Your baby is fussy or crying and can’t be soothed.
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Your child has 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, make it looser before seeking help.
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Your child has tingling in the finger or hand that's new or getting worse.
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Your child has a fever (see "Fever and children" below).
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Your child has chills.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child’s fever, tell them which type you used.
Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.
When to call a doctor about your child’s fever
For a baby under 3 months old:
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First, ask your child’s doctor how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the doctor
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the doctor
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the doctor