Finger Dislocation in Doomsday

The cooler fall temperatures mean more time for writing in the mornings before getting dressed and beginning the day.  While we don’t have the eight inches of snow on the ground that we had last year, it’s just not warm enough to be outside yet.  So I research, write, and am reminded that perhaps I want to place an order for some additional medications that we can’t purchase here in the US.

We’ve previously covered dislocations of the shoulder, hip, and ankle.  However, a finger dislocation is much more common and probably should have been addressed sooner.  Sorry about that.  The following information comes from the Ship’s Medicine Chest and Medical Aid at Sea, an excellent government (ooh, that’s an oxymoron if ever there was one) publication that you might consider acquiring.  You could put it on your wish list for Christmas. 

Finger Dislocation

The fingers are injured easily and even a minor injury may cause a dislocation.  The injury is recognized readily by the abnormal position of the two adjoining bones.  There will be pain, swelling, and shortening of the finger; and the patient may be unable to bend the finger in the injured area.

Treatment

Before a reduction is attempted, morphine sulfate 10 mg may be given by intramuscular injection for pain, and the patient allowed to rest quietly for 30 minutes to one hour.  To repeat the morphine sulfate, medical advice by radio should be obtained.  The patient should be lying down before the procedure is started, and the hand should be placed in a position with the palm down.  The finger should be grasped above and below the injured joint, with a small dressing to prevent slipping.  Strong steady traction should be applied, pulling straight out from the hand.  The bone usually with slip into position with ease.  If traction is applied to more than one joint, another dislocation could occur. 

The injured finger should be immobilized with a splint.  A padded tongue blade should be placed under the finger and secured in place with a roller gauze bandage.  (See Fig. 3-37.)  The arm should be placed in a sling.  (See Fig. 3-26.)  The patient should be examined by a physician on arrival in port.[1]

Other off-grid references provide a few additional suggestions for rendering treatment:

• As with other dislocations, reduction (returning the bones to their correct position) will be most easily accomplished and with the least amount of permanent damage to blood vessels and nerves the sooner it is performed.[2] 
• A pain reliever such as ibuprofen may lessen the discomfort for the patient.  A muscle relaxant such as cyclopbenzaprine (Flexeril), which is available by prescription only in the US, would be helpful.  (You can get this through buy-pharma.md.  Read the blogpost on this company before ordering.)
• As morphine will likely not be available, and even if it is will be saved for more serious injuries, a nerve block with local anesthetic will provide adequate pain relief during the procedure.[3] 
• With or without anesthetic, apply slow traction to reduce the finger.  Do not rush.[4]   
• Splint the finger to adjacent fingers for one week.  Do not splint the fingers straight.  They should be slightly curved.[5]

Links to related posts:

Ankle Dislocation in Armageddon

Hip Dislocation in Doomsday  

Dealing with Shoulder Dislocation in Doomsday  

The Ship’s Medicine Chest and Medical Aid at Sea  

Buy-pharma.md  Another Source for Hard-to-Get Medications 

Nerve Blocks and Medications to Have on Hand  

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[1] Ship’s Medicine Chest and Medical Aid at Sea, 1978, 84-85.

[2] Joseph Alton, Survival Medicine Handbook, 2^nd Edition, 2013, 352. 

[3] Survival and Austere Medicine, 3^rd Edition, 2017, 178-79.

[4] Survival and Austere Medicine, 3^rd Edition, 2017, 178-79.

[5] Survival and Austere Medicine, 3^rd Edition, 2017, 178-79.