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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 4933
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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My wife has dislocated her little toe. It is sticking out sideways

and very painful. It has... Show More
and very painful. It has happened before and the medical centre have managed to fix it. We are due to leave on holiday in a few hours - not enough time to visit the Dr so this time I am trying to fix it for her. No luck so far. Can you please provide some pointers?
Submitted: 7 years ago.
Category: Medical
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replied 7 years ago.

Firstly i wouldnt recommend that you try to do this yourself as it can cause many complications and also since its not working you do need to go the doctors office, that said this is the methodto reduce the joint

With the patient's hand or foot securely braced, grasp dislocated phalanx with dry gauze loosely wrapped around the phalanx (gauze improves grip) (As you are already doing with the cloth).

Hyperextend joint ( lift the joint upwards until you can lift it anymore) slightly with gentle longitudinal traction for a dorsal dislocation (upwards disclocations) or hyperflex ( push it downwards until it cant go down anymore) for a volar dislocation (downward dislocation).

Gradually push dislocated phalanx into its normal anatomical position.

As you can see fromthe instructions its difficultto perform as you need to twist and turn it in particular directions, and in inexperienced hands can cause problems. Secondly if its not going back in, it can be due to the pain as a result of which the mucles are stiff in this case a little muscle relaxant might be needed to reduce the joint back to its place.

I hope this helps.
Customer reply replied 7 years ago.
I take it the phalanx is the digit - in this case the toe?

The little toe on the right foot is sticking out sideways i.e. to the right as you look at it from above. It fells floppy i.e. you can move it left to right in a way that you can't do with the little toe on the other foot.

What I need to know is in what direction do I pull and push in order to reset the joint. As far as I can make out the joint that is dislocated is the last one - the one nearest to the end of the toe.
Dr. Muneeb Ali, Doctor replied 7 years ago.
The phalanx does mean the toe.

Well what you need to do is pull the toe downwards first, and then pull it towards the left. This should put it back in place. If it doesnt then it could be the ligaments are weak, which they are due to recurrent dislocations, and a splint will need to be applied after placing it in position.

Actually the best way to reduce it is to see the exact displacement angle, as i said before.
But the best way you can try is to pull it downwards as far as it can go and then towards the left.

If it doesnt help, go to the ER
Dr. Muneeb Ali, Doctor replied 7 years ago.
Im sorry i forgot to mention downwards, towards yourself and then towards the left....apply traction in this way. Pullit towards yourself, downwards and the left.
Customer reply replied 7 years ago.
Thanks. Just to be absolutely sure - you mean left as you look from the top? So that the joint is being straightened back to its normal orientation?

Is it necessary or desireable to rotate the toe at all? If so, in what direction? Clockwise or anti-clockwise?
Dr. Muneeb Ali, Doctor replied 7 years ago.
Yes towards the left when you look from the top, this is your wifes left sothe joint is brought back to its normal position.

Well rotation mightbe required but again that depends on the angle of dislocation which without looking at it i wont be able to describe, however generally if its rotated outwards then its anticlockwise, if rotated inwards then clockwise.

I know youre supposed to leave on your vacation but it would be best to go to the nearest ER...itll probably take the doctor there 5 mins to pop it back into place plus him being experienced the chances of aggravating it will be much less
Customer reply replied 7 years ago.
Ok thanks will give it a go.