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Finger injuries are quite common because we use our fingers in many different situations in which they can become injured. Common finger injuries include a cut or laceration of the finger, an avulsion of the skin off the finger, a fractured finger and an amputation of part or all of the finger. Dislocations can happen to the phalanges of the hand and ligamentous injuries or sprains of the finger are possible. Tendon injuries happen when a muscle is pulled and the tendon of the muscle tears or is stretched and nerve injuries can happen with impingement of the nerve or a laceration which cuts through the many nerves of the finger.
Causes of finger injury include jamming the finger against a hard object, which can cause bony, ligamentous or tendon injury. You can cut the finger with a sharp object you are working with on the job or at home. Animal bites can damage the finger and a direct blow to the finger can crush the finger or fracture a phalanx.
Several specific types of finger injuries occur include the skiers or gamekeepers thumb, which is a torn ligament between the thumb and the web space of the thumb and hand. You can also have a mallet or hammer finger which is an extensor tendon rupture of the dorsum or back of the distal phalanx. This is from a jamming injury; the finger doesn't straighten out. A boutonnieres deformity is when the dorsal tendon splits at the proximal interphalangeal joint so the finger is bent down at this particular joint. A swan neck deformity occurs when the ligament on the volar (palm side) of the finger is torn at the proximal interphalangeal joint so the finger doesn't bend normally. As you can see, there are many tendons in the finger that can be damaged during an injury.
There can be fingernail injuries, particularly a crush injury to the fingernail causing blood to build up underneath the nail. This very painful injury is called a subungual haematoma. If very painful, it needs to be drained by poking a hole into the nail bed with a hot sharp object.
Animal bites occur because the finger is the closest thing to the animal when you reach out to it. Animal bites are prone to infection, especially if they aren't cleaned out very well. Animal bites generally need cleaning out but are rarely sutured because this increases the risk of infection.
Symptoms of finger injuries include a deformity or swelling of the finger. There can be bleeding or bruising of the finger and you can have difficulty moving the finger. If there is infection, you can have redness, pus, drainage and fever from the infection that may not happen for hours to days after an open wound to the finger.
To diagnose the finger injury, the doctor does a careful history, including mechanism of injury, and physical examination of the finger. He or she will look for range of motion of the fingers, strength of the fingers and any rotational deformity of the fingers. X-rays can determine whether or not there is a fracture or dislocation of the finger. Dislocated fractures can be found on x-ray as well.
If you injure yourself at home and don't think you need to see a doctor, you need to control any bleeding and clean out any wounds thoroughly. If they are gaping, they may need to be sutured. Check the range of motion of all the fingers and thumb to make sure there is no tendon damage. Make sure there is sensation to all of the fingers. If the finger appears to be sprained, you can buddy tape it to an adjacent finger for comfort or use a splint to keep the finger in a straight and normal position until the sprain heals. If the finger is amputated, put the amputated finger in a bag of cold water and bring it to the hospital as it might be able to be retained.
Doctors can use pain medications, including over the counter medication for pain. For fracture relocation and for lacerations, lidocaine is used at the base of the finger and is injected on both sides of the finger. It numbs the entire finger and the doctor can do the work he or she needs to do to heal the finger. The finger block lasts for several hours. Severe injuries can be referred to a hand specialist.
LAWYER HELPLINE: ☎ 1800 339 958The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here