Finger Deformities After Fracture: Causes and Rehabilitation - Orthopedics

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Finger issues


Hello, doctor.
In early February this year, I had a car accident that resulted in a crooked fracture of my right hand's ring finger.
I opted for self-funded plate fixation surgery for treatment.
After the surgery, I noticed that, in addition to the limited flexion angle of the joint, my finger still felt crooked (slightly rotated towards the middle finger).
Two weeks later, during the suture removal and follow-up in early March (where an X-ray was taken to check the bone), the doctor said there was no issue with rotation.
In April, during another follow-up, the rehabilitation results showed some improvement in passive range of motion of the joint, but the overlapping of the ring finger over the middle finger during flexion was still quite evident, unless I intentionally used my uninjured hand to straighten the ring finger (which felt very tight and painful compared to overlapping with the middle finger).
At that point, the doctor mentioned that there might have been a slight rotational misalignment during the fracture reduction surgery, and since no X-ray was taken to check the bone condition, an MRI was arranged to investigate the issue further.
I am currently waiting for the report.
Q1: How can we determine if the bone has healed properly? The X-ray in March indicated that there was no issue.

Q2: If, unfortunately, the bone has not healed properly, can rehabilitation help restore the flexion angle of the finger to its original state?
Q3: If it is not a bone issue, what other problems could cause the ring finger to tilt towards the middle finger?
Q4: Aside from the issue of the ring finger tilting towards the middle finger, I still cannot fully extend or flex the finger.
Is this rehabilitation progress too slow?

Sasa, 30~39 year old female. Ask Date: 2023/04/15

Dr. Wang Shouji reply Orthopedics


Hello, based on your question, it seems that the difference in bone alignment is the cause.
However, if it does not affect future mobility and hand function, most cases do not require further intervention.
The range of motion in the finger joints may take up to six months to fully restore, primarily depending on the healing status of the bone.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2023/04/15

More Info


Understanding finger deformities after a fracture, particularly in the context of rehabilitation, is crucial for achieving optimal recovery. Your situation, involving a car accident that resulted in a fracture of the right ring finger, highlights several important aspects of post-fracture care and rehabilitation.


Q1: How can we determine if the bone has healed properly?
To assess whether the bone has healed correctly, several diagnostic tools can be employed. X-rays are the most common method, as they provide a clear image of the bone structure and alignment. However, if there is still concern about the alignment or healing of the bone, an MRI (Magnetic Resonance Imaging) can offer a more detailed view of the soft tissues, including ligaments and tendons, which may also be contributing to the deformity. In your case, since your doctor has ordered an MRI, this will help clarify whether there are any underlying issues that were not visible on the X-ray.


Q2: If the bone has not healed properly, can rehabilitation help restore the finger's range of motion?
If the bone has not healed properly, rehabilitation may still play a role, but its effectiveness will depend on the specific nature of the misalignment or deformity. If the bone is misaligned, it may require surgical intervention to correct the position before rehabilitation can be effective. Once the bone is properly aligned and healed, physical therapy can help restore range of motion, strength, and function. Rehabilitation exercises typically focus on improving flexibility, strength, and coordination, which can help in regaining the ability to bend and straighten the finger.


Q3: If it’s not a bone issue, what could cause the ring finger to deviate towards the middle finger?
If the bone is healing well, the deviation of the ring finger towards the middle finger could be due to several factors. One possibility is soft tissue tightness or scarring that can occur after an injury. This can lead to a condition known as "joint stiffness," where the ligaments and tendons around the joint become tight and restrict movement. Additionally, muscle imbalances or weakness in the surrounding muscles can also contribute to the finger's position. A thorough evaluation by a physical therapist can help identify these issues and guide appropriate treatment.


Q4: Is the current rehabilitation progress too slow?
Rehabilitation progress can vary significantly from person to person, depending on several factors, including the severity of the injury, the type of treatment received, and individual healing rates. It is not uncommon for recovery from finger injuries to take time, especially if there are complications such as stiffness or misalignment. If you feel that your progress is slower than expected, it may be beneficial to discuss this with your healthcare provider or physical therapist. They can assess your current rehabilitation plan and make adjustments as needed to optimize your recovery.


Additional Considerations
In addition to the above points, it is essential to maintain open communication with your healthcare team. Regular follow-ups and assessments can help ensure that any issues are addressed promptly. Engaging in a structured rehabilitation program tailored to your specific needs will be vital in achieving the best possible outcome.
In conclusion, while fractures can lead to complications such as deformities and restricted motion, understanding the underlying causes and engaging in appropriate rehabilitation can significantly improve your recovery. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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