Nerve Injury and Recovery After a Pinky Finger Laceration

Hand issue - Laceration of the little finger?

The left little finger sustained a glass laceration resulting in a 2.5 cm tear at the junction of the little finger and the palm.
I am scheduled to have the stitches removed next week.
Currently, the inner side of the little finger feels slightly numb, while the outer side is quite numb with a swollen sensation.
The range of motion is about 50-60% of what it was before the injury when straightened and bent.
I have consulted two doctors, both of whom mentioned that if the numbness does not improve after three months, it may indicate that the nerve has been severed and will not heal.
I would like to ask the doctor the following questions:
1.
If the sensory nerve is indeed severed, will actively engaging in rehabilitation prevent the nerve from atrophying, and is there still a possibility of reconnecting the nerve in the future?
2.
What is the critical time frame for reconnecting a nerve after injury? The initial suturing was done in the emergency room, and the doctor simply stitched the wound closed, so I am unsure if the nerve was actually severed.
3.
The tip of my little finger still has some sensation, albeit numb and swollen.
Does this indicate that it may only be a nerve injury rather than a complete severance?
I appreciate your time in addressing these three questions.
Thank you very much.

L, 30~39 year old female. Ask Date: 2018/03/01

Dr. Zhang Junwei reply Neurosurgery

If there is only a tingling sensation, it may simply indicate nerve damage, and it would be advisable to monitor the situation to see if there is a chance of recovery.

Reply Date: 2018/03/01

More Info

Injuries to the fingers, particularly those involving lacerations, can lead to a variety of complications, including nerve damage. Your situation with a laceration on your pinky finger raises several important questions regarding nerve injury and recovery. Let's address your concerns one by one.

1. Nerve Injury and Rehabilitation: If the sensory nerve has indeed been severed, engaging in rehabilitation is crucial. While it is true that a severed nerve may not regenerate fully, active rehabilitation can help maintain muscle tone and prevent atrophy of the surrounding tissues. This is important because even if the nerve does not heal completely, keeping the muscles and joints functional can improve your overall hand function. Physical therapy may include exercises to improve range of motion and strength, which can be beneficial even if the nerve does not regenerate.

2. Timeframe for Nerve Repair: The "golden period" for nerve repair is typically considered to be within 3 to 6 months after the injury. If a nerve is completely severed, surgical intervention is often necessary to reconnect the nerve ends. However, if there is a delay beyond this period, the chances of successful regeneration diminish significantly. In some cases, if the nerve is not repaired within a year, the likelihood of recovery becomes very slim. It is essential to have follow-up evaluations, including possibly an electromyography (EMG) or nerve conduction studies, to assess the extent of nerve damage and the need for surgical intervention.

3. Current Sensation in the Pinky: The presence of some sensation, even if it is described as "numb" or "swollen," suggests that the nerve may not be completely severed. This could indicate that the nerve is damaged but still intact, which is a more favorable scenario. Nerve injuries can lead to various sensations, including tingling, numbness, or a feeling of swelling, as the nerve attempts to heal. It is important to monitor these sensations over time. If they improve, it may indicate that the nerve is regenerating. However, if there is no improvement after three months, further evaluation may be warranted to determine the extent of the injury.

In summary, while nerve injuries can be concerning, there is a potential for recovery, especially if the nerve is not completely severed. Engaging in rehabilitation is essential to maintain function and prevent complications. The timeframe for surgical intervention is critical, and ongoing monitoring of your symptoms will provide valuable information regarding the healing process. If you have not already, consider consulting with a hand specialist or a neurologist for a comprehensive evaluation and tailored treatment plan.

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