Dawaa Reference

Clinical reference

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.