Addressing Post-Traumatic Nerve Issues After Finger Laceration

Issues related to severe laceration injuries of the fingers?

Hello, doctor.
Five years ago, I accidentally injured my left index finger while operating a machine, which required several stitches.
The wound has healed, but I am experiencing abnormal sensations in the area where the stitches were placed (there is very poor tactile sensation).
I have consulted a dermatologist, but they were unable to provide treatment.
Can plastic surgery help improve this issue? Thank you.

Xiao Zhuang, 40~49 year old female. Ask Date: 2021/03/07

Dr. Zhou Hongzhang reply Plastic Surgery

This is an old injury from five years ago.
It is likely that the digital nerve was damaged at that time.
Since the wound has been present for a long time, it is possible that even if the nerve has reconnected, there may not be any improvement.

Reply Date: 2021/03/07

More Info

Addressing post-traumatic nerve issues after a finger laceration can be quite complex, especially when the injury occurred several years ago. In your case, it seems that you experienced a significant injury to your left index finger, which resulted in a laceration that required suturing. Although the wound has healed, the lingering symptoms you describe—such as abnormal sensations and poor tactile feedback—suggest that there may have been nerve damage at the time of the injury.

When a finger is lacerated, especially in cases where the injury is deep or involves the nail bed, there is a risk of damaging the digital nerves that provide sensation to the finger. If these nerves are cut or severely stretched, they may not heal properly, leading to long-term sensory deficits. The symptoms you are experiencing, such as decreased sensation and abnormal feelings in the area, could be indicative of neuropathy or nerve regeneration issues.

Here are some key points to consider regarding your situation:
1. Nerve Healing and Regeneration: Nerve fibers have a limited capacity for regeneration. If the nerve was completely severed, it may not have reconnected properly, leading to persistent sensory deficits. If the nerve was only partially damaged, it might take a long time for it to heal, and even then, the recovery may not be complete.

2. Scar Tissue Formation: After an injury, scar tissue can form around the site of the laceration. This scar tissue can sometimes entrap or compress nearby nerves, leading to abnormal sensations or pain. The quality of the scar tissue can affect how well the nerve functions, and in some cases, physical therapy or massage may help to break down adhesions and improve nerve function.

3. Consulting a Specialist: Since you have already seen a dermatologist without improvement, it may be beneficial to consult with a hand surgeon or a plastic surgeon specializing in nerve injuries. They can assess the extent of the nerve damage and may suggest interventions such as nerve repair or decompression if necessary.

4. Therapeutic Options: Depending on the assessment by the specialist, treatment options may include:
- Physical Therapy: Engaging in targeted exercises can help improve function and potentially stimulate nerve regeneration.

- Medications: Certain medications, such as neuropathic pain medications, may help alleviate discomfort associated with nerve damage.

- Surgical Intervention: If the nerve damage is significant, surgical options may be available to repair or graft the nerve.

5. Timeframe for Recovery: Nerve healing can be a slow process, often taking months to years. It is essential to have realistic expectations regarding recovery and to be patient with the process.

In conclusion, while the symptoms you are experiencing are concerning, there are potential avenues for treatment and improvement. Consulting with a hand specialist or a plastic surgeon who has experience with nerve injuries is a crucial next step. They can provide a thorough evaluation and recommend a tailored treatment plan to address your specific concerns. Remember, early intervention can often lead to better outcomes, so seeking specialized care sooner rather than later is advisable.

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