Misaligned Pinky After Surgery: What to Do Next?

The finger became misaligned after the pin was inserted?

The little toe on my right foot was fractured and underwent surgery to insert a steel pin for stabilization.
About two weeks post-surgery, I noticed that the little toe was misaligned (overlapping with the ring finger).
When I consulted with doctors, they all said there was no issue.
However, during a recent visit to another doctor, it was discovered that the steel pin had shifted, causing the little toe to become misaligned as well.
The doctor mentioned that since the bone has started to heal, the only options are to either break the bone again for a revision surgery or leave it as is, which would result in the little toe remaining in this position for life.
I would like to ask for the doctor's advice.
Thank you.

Nìmíng, 20~29 year old female. Ask Date: 2017/01/21

Dr. Chen Yongxue reply Orthopedics

Hello, your message did not mention the time since the surgery.
If it has been less than a month, you can consider reopening the case.
If it has been more than six weeks, the fracture has likely begun to heal.
It will depend on your symptoms; if they significantly affect your daily life, a revision surgery may be necessary.
If the impact is minimal, it is best to allow it to heal naturally.

Reply Date: 2017/01/21

More Info

After undergoing surgery for a fractured pinky finger, it is concerning to discover that the finger has become misaligned. This situation is not uncommon, especially when surgical hardware, such as pins or plates, is involved in stabilizing the bone during the healing process. The misalignment you are experiencing, where your pinky overlaps with the ring finger, can be attributed to the improper positioning of the surgical hardware, which can lead to complications in the healing process.

When faced with the option of re-surgery to correct the alignment, it is essential to weigh the pros and cons carefully. Here are some considerations based on medical knowledge and practices:
1. Understanding the Healing Process: After a fracture, the bone typically goes through several stages of healing. Initially, a hematoma forms, followed by the formation of a soft callus, and eventually, a hard callus develops as the bone heals. If the bone has already started to heal in a misaligned position, it may be more challenging to correct it later. However, if the misalignment is significant enough to cause functional issues or pain, surgical intervention may be warranted.

2. Consulting with Specialists: It is crucial to seek a second opinion from an orthopedic specialist who has experience with hand and finger surgeries. They can provide insights into the necessity of re-surgery and whether the current alignment poses a risk for long-term complications, such as arthritis or impaired function.

3. Risks of Re-surgery: Any surgical procedure carries risks, including infection, nerve damage, and complications related to anesthesia. If the decision is made to proceed with re-surgery, ensure that you discuss these risks with your surgeon. Understanding the potential outcomes can help you make an informed decision.

4. Non-surgical Options: If the misalignment is not causing significant pain or functional impairment, some patients opt to leave the finger as is. However, this decision should be made with caution, as it may lead to long-term issues. Physical therapy might be recommended to improve mobility and strength in the finger, even if it remains misaligned.

5. Post-operative Care: If you decide to go ahead with the corrective surgery, follow your surgeon's post-operative care instructions meticulously. This includes keeping the surgical site clean, attending follow-up appointments, and engaging in rehabilitation exercises as recommended.

6. Long-term Considerations: Consider the long-term implications of both options. If you choose to undergo the corrective surgery, it may lead to a better functional outcome and aesthetic appearance of the finger. Conversely, if you opt to leave it as is, be prepared for the possibility of ongoing issues with finger function or discomfort.

In conclusion, the decision regarding whether to undergo corrective surgery for your misaligned pinky finger should be made after thorough discussions with your healthcare provider. Weigh the risks and benefits of re-surgery against the potential for long-term complications if left untreated. Ultimately, your comfort and functionality should guide your decision-making process.

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