msBahasa Malaysia

Definition

What is a finger injury?

You use your fingers and thumbs to do everything from grasping objects to playing musical instruments to typing. When there is something wrong with them, it can make life difficult. Common problems include:

  • Injuries that result in fractures, ruptured ligaments and dislocations
  • Osteoarthritis – wear-and-tear arthritis. It can also cause deformity.
  • Tendinitis – irritation of the tendons
  • Dupuytren’s contracture – a hereditary thickening of the tough tissue that lies just below the skin of your palm. It causes the fingers to stiffen and bend.
  • Trigger finger – an irritation of the sheath that surrounds the flexor tendons. It can cause the tendon to catch and release like a trigger.

How common is a finger injury?

Finger injuries are quite common. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of a finger injury?

Although bleeding, bruising, deformity or swelling of an injured finger may be obvious, significant injuries may be present that are not obvious right away. Some symptoms, such as the redness, pus, and fever of an infection, will not develop for hours to days.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Severe pain or deformity
  • Uncontrolled bleeding
  • Numbness (loss of sensation)
  • The finger is pale or bluish in color
  • Exposed bones or tendons

Go to a hospital’s emergency department if these conditions develop:

  • The patient has heavy bleeding or bleeding that does not stop.
  • There is obvious missing tissue or amputation.
  • There is obvious deformity of the finger.
  • A cut gapes open or goes deeper than the very top layer of skin.
  • The patient is unable to completely clean out the dirt or foreign bodies from a wound.
  • There is an area of numbness or weakness.
  • The patient is unable to use the finger normally.
  • The patient develops redness, drainage, pus, swelling, fever, or other signs of infection.

Causes

What causes a finger injury?

A finger may be injured by a direct blow or cut. Many injuries are work-related. The finger may also be jammed, twisted, or stretched playing sports. Animal bites are another common cause of finger injuries.

Jammed finger

A direct blow to the tip of a finger can cause tendon or ligament damage, as well as fracture or dislocation of the bones.

If the side ligaments are torn, the patient may have pain on the side of a joint, and the joint may be loose.

If the ligament on the bottom of the joint (called the volar plate) is torn, the patient may have pain and looseness on the underside of the finger.

If a tendon is torn away from its attachment, the patient may be unable to completely bend, straighten, or grip with the finger (or thumb).

Several common kinds of injuries that can result from jamming a finger:

  • Skier’s (gamekeeper’s) thumb: Torn ulnar collateral ligament (the ligament between your thumb and palm in the web space of the thumb and hand), often caused when a skier falls on his or her pole with an open hand.
  • Mallet (or drop or hammer) finger: Extensor tendon (the tendon that is on the back or “dorsum” of your finger responsible for extending the finger straight) torn away from the distal phalanx (bone in the end of your finger). This causes the tip of your finger to sag and not completely straighten out.
  • Boutonniere deformity: The stabilizing portion of the extensor tendon (the tendon that is over the backside of your finger) is torn between the proximal and middle phalanges (the closest and middle bones of your finger). This causes an inability to straighten the joint between the proximal and middle phalanges.
  • Swan neck deformity: Volar ligament (ligament on the palm side of your finger responsible for flexing your finger) torn between the proximal and middle phalanges. As this injury heals, the ligament gets lax and the finger bends in a characteristic “swan neck” pattern.

Fingernail injuries

The nail bed, which is the supportive tissue underneath the nail, can be damaged by a cut or blow.

Sometimes this leads to a collection of blood under the nail, called a subungual hematoma.

Subungual hematomas can be very painful and sometimes need to be drained.

If the nail is severely damaged, it may need to be removed.

Bites

Animal bites can cause tissue damage and also can lead to serious infections if not treated properly.

A human bite would is often more serious than an animal bite would. It usually happens from punching someone in the mouth with a closed fist (called a “fight bite”). These wounds require thorough cleaning and often antibiotics.

Paronychia

A paronychia is an infection in the area where your fingernail attaches to your finger.

It often starts after minor trauma such as a hangnail or nail biting.

Risk factors

What increases my risk for a finger injury?

Please discuss with your doctor for further information

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is a finger injury diagnosed?

The doctor will want to examine the patient’s hand, including testing strength, sensation, and range of motion of the injured area. If the doctor suspects a fracture, or a foreign body such as glass or metal in the wound, X-rays may be ordered. X-rays do not show all types of foreign bodies, nor do they show injuries to tendons or ligaments (such as sprains and strains).

How is a finger injury treated?

Treatment for finger injuries depend on the type of injury. Some finger injuries can be treated at home (for example, buddy taping a broken finger). Other more serious injuries to fingers (fractures, dislocations, deep cuts or wounds) will need medical treatment.

Pain management

Before treating the injury, the doctor may numb the tissue with a local anesthetic such as lidocaine. This is usually done by injecting an anesthetic near the base of the finger, called a “digital block”.

A digital block is done with a small amount of lidocaine placed on either side of the base of the finger where the main branch of the nerve is located. This provides anesthesia (numbing) to the entire finger with a minimum amount of needle shots and pain.

The patient may also be given pain medications by mouth or through an IV.

Open wounds

If the patient has an open wound such as a laceration or an avulsion, the doctor may want to explore the wound more carefully to assess the damage or to remove foreign bodies.

The wound will then be thoroughly washed.

The nail bed, tendons, or other deep structures are sometimes sutured (stitches sewn to close the wound) with absorbable (dissolving) thread.

Thread used to close the skin usually does not absorb, and stitches will need to be removed in one to two weeks.

Some wounds are temporarily closed with loose stitches until the patient can be seen by a hand surgery specialist in a day or two.

Avulsions and amputations

The separated tissue may be able to be reattached to the finger.

A piece of tissue that is very small, is severely damaged, or has been separated for a long period may not be salvageable. Reattachment of amputations closer to the base of the finger (more proximal), especially ones that include the middle part or base of the finger, are more likely to be attempted by the hand surgeon.

Skin grafting is used in some cases where a large piece of skin is missing.

Subungal hematoma

A large (>50% of nail surface) or very painful patch of blood can be drained from under the nail by “trephination.”

Trephination is done by boring a few holes in the nail to relieve the pressure and drain the blood. This can be done with a red-hot cautery device (a heated metal probe), a needle twisted through the nail, or a small drill device.

Paronychia

This infection of the lateral nail fold is drained by putting a small incision in the skin overlying the infected area. It is then cleaned, and antibiotics are placed on it. Depending on the severity of the infection, the patient may need oral antibiotics.

Fractures and dislocations

Reduction (realignment) of broken or dislocated bones usually takes place in the emergency department under local anesthesia.

After the bone is put back into place, the doctor may perform more X-rays to make sure the bones are realigned, then a splint is applied.

Some fractures and dislocations require surgery to repair.

Splinting

Fractures, dislocations, tendon injuries, and some lacerations may be treated by splinting part of the finger or even the whole hand or wrist.

This splinting allows the tissues to rest and therefore heal faster.

Antibiotics

Some wounds are at higher risk of infection than others and may be treated with antibiotics.

If the doctor prescribes antibiotics, it is very important the patient take the medication as directed and finishes the whole prescription even if the patient feels fine.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage a finger injury?

The following lifestyles and home remedies might help you prevent finger injuries:

  • Be careful of chain saws, snow blowers, paint and grease guns, and other high-powered equipment.
  • Wear heavy leather gloves and do not wear rings or other jewelry when operating such equipment.
  • Use and store kitchen knives carefully.
  • Never reach blindly into a sink or drawer containing a knife.
  • Be aware that many finger injuries occur during athletic events, especially ball games (such as, basketball, baseball, football). Remove rings or other jewelry before participating in sports.
  • If you enjoy participating in such activities, keep some first aid items on hand for splinting a finger.
  • The most common way you can be bitten on the hand is when trying to separate two fighting animals.
  • Even your loyal dog can accidentally bite you during a fight.
  • Stay out of the way.
  • Do not approach or try to hand feed feral (animals).

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: October 26, 2017 | Last Modified: October 26, 2017

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.