Nine weeks ago I had my middle finger right hand crushed and it was confirmed by X-ray that I had a fracture Quote 'of the dorsal aspect of the base of distal phalanx' end quote. I saw my Orthopaedic specialist who got me to have the finger splinted and I was handed over to a hand therapist for on going treatment. 2 weeks ago I saw my Ortho specialist who said I could remove the splint and only use it at night. My hand therapist said not to remove during the day unless doing nothing with the hand. Ok so differing opinions there!! I notice that the finger is still very swollen at the joint and tending to still bend.
The original assessment by my GP was a classic Mallet crush injury-fair enough that made sense!
So still being badly swollen and damn painful I saw my GP who was somewhat taken back, sent me for a follow up X-ray and there is absolutely no change after nine bloody weeks. WTF!!!
So now it is back to the Ortho again who I cant see for another week. I think I will chop the damn thing off it is useless at present and the splint is now back on full time and performing its useless duties...
Nine weeks ago I had my middle finger right hand crushed and it was confirmed by X-ray that I had a fracture Quote 'of the dorsal aspect of the base of distal phalanx' end quote. I saw my Orthopaedic specialist who got me to have the finger splinted and I was handed over to a hand therapist for on going treatment. 2 weeks ago I saw my Ortho specialist who said I could remove the splint and only use it at night. My hand therapist said not to remove during the day unless doing nothing with the hand. Ok so differing opinions there!! I notice that the finger is still very swollen at the joint and tending to still bend.
The original assessment by my GP was a classic Mallet crush injury-fair enough that made sense!
So still being badly swollen and damn painful I saw my GP who was somewhat taken back, sent me for a follow up X-ray and there is absolutely no change after nine bloody weeks. WTF!!!
So now it is back to the Ortho again who I cant see for another week. I think I will chop the damn thing off it is useless at present and the splint is now back on full time and performing its useless duties...
Peter, I worked a few years in rehab including hand therapy, so I can recall a thing or two. Here is my assessment:
Doral aspect of the base if the distal phalanx: meaning you had a fracture to the finger nail side (as opposed to the finger tip side) of your middle finger, literally under the finger nail towards the last knuckle joint.
Splinting: how is it done? Is it in a thermoplastic "sleeve" on its own or a "buddy splint" with the ring finger? Both would be OK depending if it's on your dominant hand or not. The idea is for the last finger knuckle joint to be immobilised while the fracture heals. The splint should keep the last finger joint flat, but you should do some gentle bending of the joint a few times a day to avoid fluid build up.
Healing: This can take up to 8 weeks depending on other medical conditions such as diabetes (which will delay it due to poor blood circulation to the fingers and toes).
Rehab: take a photo of your splint and post it here. If it's been two weeks or more and you don't have diabetes or blood circulation issues. You should be doing finger exercises (gentle bending, on its own without push by other hand). You can also try warm water baths to relax the joint esp at morning and night 5 mins before your finger exercises to relax the joint).
Sleep with your hand in a pillow above your chest, which will minimise swelling.
Repeat and wait, bones take time to heal!
Cheers
Bo
Yup as Bo said, as a victim of a finger injury they do take some time to heal. Mine from Jan '15 was about 12 weeks in and out of a elastic tube bandage after some minor reconstructive surgery. It looks pretty good now although it still has some touch sensitivity problems, joint aches and stiffness and this is 15 months later. Do as BO says and just take it gently.
HI !
As everyone has said- may take time.
However if your dorsal fragment was an avulsion type injury in which the conjoint part of the extensor mechanism tears off a chunk of bone, if that is not sticking back down with a splint - (? is it a finger spica splint?) after ten weeks then maybe a repair is in order to either pin or suture tendon / tendon+ bony fragment.
Certainly if this is your dominant hand and it is still deformed I would be approaching the Ortho again.
Thanks guys. Graham I believe that is what has happened. Photo's attached.
The image of the finger is somewhat flattened as I took the splint off to take the image
Yes, looks like you do need to keep the splint on for a while. Soft tissue injuries take 3 months to heal assuming no complications.
Long wait ahead Peter.
Don't ask Andrew, it was not my fault. I was helping a mate cut logs 9 weeks ago. Was moving this log into position when he decided to jump on it with my hand under it..Had thick leather gloves on as well, so the mind boggles what it would have looked like if I had no protection at all.
Here is the original injury the only difference between then and now is some of the bruising has gone and the nail has grown. Too damn sore to chew......
I had a virtually identical injury to the third finger on my right hand.
Trapped my gloved finger in a moving hydraulic part of a mobile crane.
Squashed it flat without breaking the skin, broke the last bone just next to the knuckle same as you. I hope you do better than i did. Took a very long time for the break to repair, my physio said that in all probability the bones wouldn't knit together again because of splinting difficulties and movement. She said that most likely a natural cartilage substitution would create a bridge between the two. Three years later the joint is a bit lumpy and different, but the pain and tenderness has gone and it works almost
as well as the others. See, there is light at the end of the tunnel,its just that it might be a very long tunnel.
Good luck,
Frank.
Hope it heals up ok Peter looks nasty ,all my finger joints look like that more or less if that helps you some ,some from old breaks ,some from osteo,,,mostly age and logs
Graham Stevens has some good advice. Bones take an awful amount of time to heal, it's rather hard to get an accurate opinion without viewing the Xays. Usually fractures of hands and fingers are dealt by plastic surgeons but orthopaedic surgeons do cover this area. Plastic surgeons will also manage the soft tissue damage such as nerves and ligaments.
Swelling and bruising is perfectly normal also. The main concern will be ongoing pain which can't be managed by simple analgesia, increased swelling, wound break down and offensive discharge all due to infection.
Healing time can be impeded by poor circulation, nutrition,age and infection.
So be patient and see your GP if you have any queries.
To answer your question I would consult with your Orthopaedic surgeon and mention the advice given by the hand therapist.
Regards Paul.
Yeah Paul, I see the Ortho on Thursday, frightened he will want to pin it. I have had more than my share of operations in my 68 yrs, at last count 22 of them..so do not want any more..
Well that was interesting, the specialist said we have 2 options. The first is to fuse the joint, and the second wear the splint for another 2 months and see him after that for another analysis. Stuff a stoker, what a great choice....
