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Why does my son's thumb get dislocated frequently?

Q: My son is two and half years old. While playing with me the middle part of his right thumb got pressed against me and got dislocated. The doctor corrected it by applying bandage and left it like that for 5 days. But now without any impact his thumb gets dislocated and after pulling it, it comes back to the normal position without any problem. We don't have to apply any pressure to pull it. The frequency of dislocation is less now. But it still happens. The doctor says it has to be operated upon, which I am against. My son has a good grip in both the hands. He holds my fingers strongly and uses the thumb to press it. What should I do?

A:Your son seems to be having a (post-traumatic) habitual dislocation of the inter-phalangeal joint of thumb. Definitely not a common scenario! From what you stated, it seems that the frequency of the spontaneous dislocation is decreasing. What is important is to make sure that the joint is fully reduced and maintained in that position (if possible). If he is not complaining and has full function, and the joint is mostly properly reduced, then it is best left alone. Any complaints, along with loss of function (as compared to other side) would force an orthopaedic surgeon (pediatric orthopaedic or a hand surgeon) to consider surgery.

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