Closed dislocations that can be reduced, can be treated with a brief period of rest, ice, compression, hand elevation, early protected motion and protective splint (blocking splint) that is placed in an angle that limits motion beyond a certain point initially so a dislocation does not recur during the healing stage. Another treatment option called buddy splinting is when the injured digit is bound to the adjacent digit to serve as a dynamic splint, to protect from further trauma while permitting motion that prevents stiffness.
Dislocations that are open, irreducible, associated with instability, subluxation, recurrent dislocation or associated with a fracture that renders the joint unstable requires surgical intervention. Surgical options may consist of attempting a closed manipulation and percutaneous pinning, open release of offending reduction restraints and ligament repairs as indicated, and finally open reduction with internal fixation of the fracture when present. Open dislocations and irreducible dislocations need emergent treatment due to the increased risk of infection and vascular compromise. Most dislocations can be followed with a HEP focused on early protected range of motion. Some patient with more complex dislocations or associated injuries will require of a formal hand therapy program according to the associated injuries.