# Finger dislocation - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - Referral & safety-netting (no drug therapy) - Lidocaine — injection ## Complete treatment card ```text FINGER DISLOCATION 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 Review status: REVIEWED against the source listed above (2026-08) 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 Source StatPearls "Finger Dislocation" - disease-level clinical article Status 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 Finger joint dislocation from sports or a fall; needs reduction and splinting, with an X-ray to exclude an associated fracture. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. 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. Caution 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 [1st line] Adult 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 Peds 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. 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. Caution 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. Egypt LIDOCAINE HYDROCHLORIDE 10MG/ML AMP. 2 ML PHARCO B 2.00 EGP LIDOCAINE HYDROCHLORIDE 10MG/ML AMP. 5 ML PHARCO B 4.00 EGP LIDOCAINE 1% (OTSUKA) AMP. 5 ML OTSUKA 5.00 EGP LIDOCAINE HCL PHARMACELL 2% VIAL IM IV SC 20 ML BADR PHARMA > PHARMACELL 9.75 EGP LIDOCAINE HCL 20MG/ML VIAL IM IV SC 50 ML (NET PRICE) SIGMA TEC > VODACHEM 11.25 EGP DEBOCAINE HCL 2% 50ML VIAL ARABCOMED > D... 33.00 EGP ULTRACAINE 20MG/ML VIAL 50 ML MEMPHIS 33.00 EGP LIDOCAINE 2% 10 AMP. ALEXANDRIA 90.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)