A Twist of Fate

Fingers

Dislocation here is usually from dropping onto a finger that's wedged in a crack or pocket, or falling onto an outstretched hand. If you dislocate your finger, it will feel like you compressed the end of it while trying to catch a football or softball. If one bone of the joint has slid up over the other, the injured finger may appear shorter than its mirror image on your other hand. If the bones have moved laterally, the finger may have a kink, like a bayonet on a gun barrel, or point off in an abnormal direction. In all cases the joint will be swollen, and you will probably not be able to bend or straighten your finger.

All dislocations should be immobilized. With fingers, you can use an adjacent finger as the splint. Place some thin padding (a thin sock, glove, or gauze bandage work well) between and around the two fingers, and tape the injured finger to the adjacent one. Tape above and below the joint firmly, but not so tightly that fingers turn numb or blue. Then avoid moving or putting any pressure on the finger. If possible, apply ice, snow, or cold water to the injury for 20 minutes every hour to reduce swelling and pain.

Toes

A toe is most often dislocated by twisting it in a crack or pocket, landing pirouette-style on the ground, or stubbing it against the rock. If you are wearing climbing shoes, you will feel a throbbing pain, as if somebody had dropped a brick on your toe. If you are wearing sturdier footgear, however, the pain may be much less noticeable as the toe is receiving support from adjacent toes and the boot itself. Unless the conditions are freezing—don't risk adding frostbite to your injuries—remove your boot to examine the injury.

Toes are important for balance and locomotion, and while a dislocated toe might appear to be less critical than a finger, in the backcountry the reverse may be true. You can often avoid using a finger on the walk out; it's harder to avoid using one of your toes.

In general, treat toes the same as fingers. Place thin padding between and around two toes, and"buddy tape" the dislocated one to the adjacent toe. Walking, especially with a dislocated big toe, is usually painful, so plan on a protracted evacuation and get ready to ask your partner for assistance. Ice the toe as you would a finger.