Houston Methodist. Leading Medicine

Hand FAQ

Question:

What is a closed manipulation? Our 21-year-old son off to college had a football injury. His index finger got stuck and couldn't open all the way. He said it was taken care of with a closed manipulation. Is this a chiropractic treatment?

Answer:

A chiropractor could put a subluxed or dislocated joint back in place with a manipulation. In this case it's more likely an orthopedic surgeon or the team doctor injected a local anesthetic like novacaine into the joint. Gentle traction is applied by pulling the bone away from the joint. The finger is straightened and rotated or turned slightly.

The joint usually responds to this treatment and the bones go back into place normally. This is called a closed reduction or manipulation. The doctor must be careful not to use too much force in order to prevent fracture or bleeding in the joint.

If a closed reduction doesn't work then surgery may be needed. An opening is made with an incision to see inside. The soft tissues around the joint are examined. Sometimes the problem is a ligament that has gotten caught under the bone or inside the edge of the joint. Sometimes the problem is inside the joint and the surgeon must cut the joint open. Whatever is causing the locking is removed or repaired.

Richard J. Thomas, MD, et al. Locked Metacarpophalangeal Joint in a 20-Year-Old Football Player. A Case Report. In The American Journal of Sports Medicine. January 2006. Vol. 34. No. 1. Pp. 29-31.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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