Broken finger needs help

[rayrodo]

I broke my little fingure 5 weeks ago and have some questions. It is very stiff and crooked and still painful. Is there any exercise i can do with my fingure to improve movement as well as improve strength?

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[physiobob]

You first need to confirm that the fracture in united. Was it splinted? Did you have an x-ray? What advice have you already been given.

[rayrodo]

X-rays were taken when the finger was broken. a ball hit me on the tip of the finger and pushed it so hard in towards my hand , bang on, that i split the finger bone as it joined on the the knuckle part of the hand. The finger has been strapped for the last 5 weeks to my ring finger to brace it and support it. as of Yesterday i have decided to leave it unstrapped in order to try and get more moement in my finger and to get rid of the stiffness. The finger closes most of the way and almost opens straight but still tends to be a little bent when extened to max.

I wanted to know if there was any stretching exercise or bending or straighting excercise to help the finger become more mobile as well a become less stiff.

Any advice on the matter will be greatly apprciated.

[physiobob]

I'd suggest just giving it time and simple use the hand. There are cartilage components at the joint line areas that will need some time and you shouldn't force them in case they were also damaged. X-rays unfortunately don't show these structures.

[rayrodo]

Thanks for the advice, I will do so.

[newbie123]

Just rest your hand, do nothing with it until told to by your doctor

[Hankfreid]

The fingure has been strapped for the last 5 weeks to my ring fingure to brace it and support it. as of Yesterday i have decided to leave it unstrapped in order to try and get more moement in my fingure and to get rid of the stiffness. The fingure closes most of the way and almost opens straight but still tends to be a little bent when extened to max.

[Lisa003]

I have recently had a specialty placement in hands, and believe I can address this issue. You're describing potentially an intra-articular fracture of the D5 MCP level.
The general guidelines for conservative treatment (since you were put in a splint I'm assuming) are as follows:


Treatment Guidelines
Protective splinting/casting 3-6 weeks
4 wks commence gentle AROM (if stable fracture may commence out of splint)
6 wks gentle PROM, night splinting for protection, may commence gentle resisted (i.e. putty)
8 weeks before you can commence grip strength

You also mentioned that your finger has been strapped for the last 5 weeks to your ring finger to brace it and support it. Please stop this! This is called 'buddy fingering' and can actually cause more malrotation and deformity.

In terms of exercise, I would recommend doing the following exercises every 1-2 hours (except when sleeping):
-with wrist in neutral: make a fist, then straighten all your fingers
-try and touch the tip of your little finger to the tip of your thumb
-using your non-injured hand, block your little finger so only the tip can bend and straighten (i.e. the DIP joint).
-using your non-injured hand, block your little finger so the PIP & DIP joint are bending and straightening (MCP joint remains still)
-place your injured hand on a small ball or on top of your non-injured hand (because we want your injured hand to be slightly cupped so your MCP joints are slightly bent). Now straighten all your fingers (i.e. extend your MCP joints).
Repeat all these exercises 3-10 times depending on your pain tolerance.

You should be able to commence passive ROM, but as always - it is recommended you have this cleared with a physician first.

If you have a plastics physiotherapy department available where you live (in the hospital), I would recommend going there. Sometimes when you fracture your finger the way you did, it can result in a volar or dorsal dislocation, leading to further problems such as a Boutonniere or swan-neck deformity. They can also do passive joint mobilizations to improve the normal arthrokinematic movement at the MCP joint.

Cheers,
Lisa

[prateekgupta]

Finger injuries in athletics are very common. Most of these injuries are small however, some can be major. It is very important, especially in the skeletally immature athlete, to not miss a potentially debilitating injury.
An Athletic Trainer will be the front line medical professional with athletes and many times will treat the injury immediately after it has occurred.The history should include mechanism of injury, previous injury, whether the joint was dislocated (out of place) and if so, how it was reduced.
Any finger injury that is sustained should be seen by a physician and have x-rays performed. These patients are very susceptible to developing debilitating joint arthritis later in adulthood.
The joints of the finger are comprised of the two bones, ligaments, and tendons. The dynamic interaction of these structures maintains the stability of the finger joints.
The most common joint injured the proximal-interphalangeal (PIP) joint (the middle joint of the finger). The most common mechanism of injury is hyperextension. The joint is straightened too far. Other common mechanisms of injury are torsion and axial loading. The distal interphalangeal (DIP) (joint near the finger nail) is injured less often due to the small size of the distal phalanx (finger bone). Its small size means that it would take a major force moment to injure this joint.
A hyperextension mechanism to any joint of the finger, either to the PIP or DIP, can result in a sprain of the volar or palmar plate. The volar plate is a very thick ligament that prevents hyperextension injuries. If the force is sufficient enough, the joint may be dislocated. The most common dislocation of the PIP results in dorsal (upward) displacement of the middle phalanx.
A simple hyperextension may result in a small avulsion (chip) fracture of the volar plate. This injury is most often treated with immobilization. In contrast, a hyperextension that results in dislocation can produce a much larger fragment. The fragment needs surgical treatment to repair.

For more details please contact:
Dr. Prateek Gupta (Senior Surgeon)
Arthroscopy Surgery Clinic
C2/5 Safdarjung Development Area (SDA),
Aurobindo Marg, New Delhi - 110016
INDIA
Telephones: +91 9810852876, +91 11 26517776
24 x 7 Helpline & Appointment: +91 9810633876