Open Finger Fractures: Recovery and Concerns

Open fracture of the finger?

Hello Doctor, I sustained an injury at work on March 9th, resulting in an open fracture of the middle phalanx of my right ring finger.
I underwent surgery where a steel pin and a wire were inserted.
The pin was removed on April 24th, but in the past few days, I have noticed some slight lateral movement at the fixation site.
Could you please advise if the pin was removed too early and whether the bone has not formed a callus yet?

Xiao Kai, 20~29 year old female. Ask Date: 2024/04/27

Dr. Zhou Hongzhang reply Plastic Surgery

1.
After the removal of the steel pin, it is still necessary to immobilize and protect the finger with a splint for at least 3 weeks.

2.
Sometimes, the bone and/or joint may not have fully healed, which can result in some instability.

3.
It is advisable to return to the original physician's office for consultation to assess any issues.

Reply Date: 2024/04/27

More Info

Open finger fractures, particularly those involving the middle phalanx, can be quite complex and require careful management to ensure proper healing and function. In your case, it sounds like you experienced an open fracture of the middle phalanx of your right ring finger, which necessitated surgical intervention involving the placement of a pin and wire for stabilization.
The term "open fracture" refers to a fracture where the bone is exposed through the skin, which significantly increases the risk of infection and complicates the healing process. The surgical procedure you underwent was likely aimed at realigning the fractured bone and stabilizing it to promote healing. The use of a pin and wire is a common method to achieve this, especially in cases where the fracture is unstable or involves significant displacement.

Regarding your concern about the removal of the pin on April 24th and the subsequent feeling of movement at the fracture site, it is essential to understand that the timing of hardware removal is typically based on the healing progress observed through follow-up X-rays and clinical assessments. In general, pins are removed once the bone has sufficiently healed to maintain stability without them. However, if you are experiencing noticeable movement at the fracture site, it could indicate that the bone has not yet fully healed or that there is some instability at the fracture site.

Bone healing occurs in several stages, including the formation of a hematoma, the development of a soft callus, and eventually the formation of a hard callus (also known as bone callus). If you feel that the area is still unstable, it may be beneficial to consult with your orthopedic surgeon. They can perform imaging studies, such as X-rays, to assess the healing process and determine whether the bone has formed a sufficient callus to support normal function without the pin.

In terms of recovery, it is crucial to follow your surgeon's recommendations regarding rehabilitation and activity levels. If the bone has not fully healed, engaging in activities that place stress on the finger could lead to complications, including delayed healing or re-injury. Physical therapy may be recommended to help restore range of motion and strength once the fracture has healed adequately.

If you have concerns about the timing of the pin removal or the stability of the fracture site, it is advisable to seek a second opinion or return to your orthopedic surgeon for further evaluation. They can provide you with the most accurate information based on your specific situation and imaging results.

In summary, open finger fractures require careful monitoring and management to ensure proper healing. If you are experiencing instability at the fracture site after pin removal, it is essential to consult with your healthcare provider to assess the healing process and determine the best course of action for your recovery.

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