Dawaa Reference

chronic

Finger dislocation

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

Finger Dislocation - StatPearls - NCBI Bookshelf (NBK551508) - https://www.ncbi.nlm.nih.gov/books/NBK551508/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD48.02 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Lidocaine Hydrochloride Injection DailyMed label, SetID 01679d29-a592-8cbb-e063-6394a90ad82a, Dosage and Administration Table 1

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • Joint pain, swelling that can spread to nearby tissue, and a visible deformity at the site are the typical presentation [joint pain · visible deformity]
  • Some dislocations have already been put back in place by the patient or someone else before the visit, so it is worth asking whether that was tried

Signs — what you find (5)

  • Dimpling or puckering of the skin over the joint can mean soft tissue is trapped inside it
  • Fingers that overlap or scissor when making a fist point to a rotational component of the injury
  • Increased laxity or gross instability on stress testing suggests one of the stabilizing ligaments or the volar plate has been injured
  • Weak extension at the middle joint with a rigid end joint on testing suggests a torn central slip
  • Comparing the injured finger to the same finger on the other hand for light touch, pinprick, or two-point discrimination screens for a nerve injury

Tests (4)

  • Posteroanterior, oblique, and true lateral X-rays of the affected finger are the standard first imaging
  • A widened joint space on X-ray can mean soft tissue, such as the volar plate, is caught inside the joint
  • A trapped sesamoid bone on imaging of a knuckle dislocation strongly suggests a complex dislocation
  • A rotational deformity is usually caught on physical exam rather than on plain films

If not this — what else fits (3)

  • A fracture-dislocation must be told apart from a simple dislocation
  • An isolated collateral ligament sprain, a boutonniere-type deformity, mallet finger, or a swan-neck deformity are also considered
  • Dupuytren contracture is also on the list

SourceStatPearls "Finger Dislocation" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Main treatment | Digital nerve block before reduction

MAIN TREATMENT

1

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Adult dose and duration

Finger joint dislocation from sports or a fall; needs reduction and splinting, with an X-ray to exclude an associated fracture. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Finger joint dislocation from sports or a fall; needs reduction and splinting, with an X-ray to exclude an associated fracture.

Cautions
  • Open dislocation, failed or unstable reduction, neurovascular compromise of the digit.
  • Referral is the pathway; the medicines listed alongside are what primary care can give before or while it happens.

DIGITAL NERVE BLOCK BEFORE REDUCTION

2

LIDOCAINE

Digital nerve block before reduction

1st line

Forminjection

Adult dose and duration

Plain lidocaine 0.5% or 1% infiltrated around the digital nerves - the label's range for percutaneous infiltration is 1 to 60 mL and 5 to 300 mg in total, and a digit needs only the low end. Never exceed 4.5 mg/kg or 300 mg. - Single block; do not repeat within 2 hours

Paediatric dose

Use a solution weaker than 2% so the volume can be larger, and keep the total below 5 mg/kg and below the adult ceiling of 300 mg per dose; do not repeat within 2 hours.

Dose source

Lidocaine Hydrochloride Injection DailyMed label, SetID 01679d29-a592-8cbb-e063-6394a90ad82a, Dosage and Administration Table 1 - verbatim: "Infiltration Percutaneous 0.5 or 1.0 1−60 5−300"

Why

A finger dislocation is reduced in the clinic, and the article makes a digital block a precondition of even attempting it; without it there is a procedure and no anaesthetic.

Cautions
  • Use a plain preparation. Do not use lidocaine premixed with adrenaline for a finger block.
  • Aspirate before injecting and inject slowly - accidental intravascular injection causes the tingling lips, ringing ears, confusion and fits of local anaesthetic toxicity.
  • Work out the ceiling for the patient's weight before drawing up, and stay well under it: 4.5 mg/kg and never more than 300 mg without adrenaline.
  • Check and record the sensation and capillary refill of the finger before and after the block, and X-ray after reduction.
  • Lower the dose in the elderly, the debilitated, and in heart or liver disease.
Egyptian brands
Egyptian brandManufacturerIndicative price
LIDOCAINE HYDROCHLORIDE 10MG/ML AMP. 2 MLPHARCO B2.00 EGP
LIDOCAINE HYDROCHLORIDE 10MG/ML AMP. 5 MLPHARCO B4.00 EGP
LIDOCAINE 1% (OTSUKA) AMP. 5 MLOTSUKA5.00 EGP
LIDOCAINE HCL PHARMACELL 2% VIAL IM IV SC 20 MLBADR PHARMA > PHARMACELL9.75 EGP
LIDOCAINE HCL 20MG/ML VIAL IM IV SC 50 ML (NET PRICE)SIGMA TEC > VODACHEM11.25 EGP
DEBOCAINE HCL 2% 50ML VIALARABCOMED > DEBEIKY33.00 EGP
ULTRACAINE 20MG/ML VIAL 50 MLMEMPHIS33.00 EGP
LIDOCAINE 2% 10 AMP.ALEXANDRIA90.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.