Seeking Orthopedic Advice: Finger Injury and Treatment Options

Q: Seeking Orthopedic Advice: Finger Injury and Treatment Options

Dear RYO： Based on your condition, it is likely that you have a rupture of the extensor tendon of the index finger, resulting in what is known as "mallet finger." If this occurred acutely, treatment with aluminum splinting could be effective. <br>Since your condition has persiste

Orthopedic doctor?

I consulted an orthopedic doctor.
Over a year ago, my left index finger was accidentally punctured by a nail from a pneumatic gun while working, entering from the left and exiting from the right.
Initially, only the nail was removed, and no further treatment was done.
I'm unsure if the tendon has atrophied or if scar tissue is pressing on the tendon, causing the first segment of my finger to not straighten.
Would surgery be beneficial? Are there other methods available?

RYO, 20~29 year old female. Ask Date: 2004/11/24

Dr. Chen Xingyuan reply Orthopedics

Dear RYO: Based on your condition, it is likely that you have a rupture of the extensor tendon of the index finger, resulting in what is known as "mallet finger." If this occurred acutely, treatment with aluminum splinting could be effective.
Since your condition has persisted for over a year, surgical intervention may be necessary; however, a proper assessment through X-ray examination is required to confirm the actual situation.
I recommend that you consult an orthopedic specialist to evaluate your condition.

Reply Date: 2004/11/24

More Info

I'm sorry to hear about your finger injury. It sounds like you've been dealing with a challenging situation for quite some time. Given the details you've provided, it seems that your left index finger has been affected significantly since the puncture wound from the nail gun. The inability to fully extend the first segment of your finger could be due to several factors, including tendon damage, scar tissue formation, or joint stiffness.

Understanding Your Condition
1. Tendon Injury: If the puncture wound affected the tendons responsible for finger extension, this could lead to a condition known as "mallet finger," where the finger cannot be straightened at the distal joint. Tendons can also become scarred or adhesed to surrounding tissues, limiting movement.

2. Scar Tissue: Scar tissue can form after an injury, which may restrict the normal movement of tendons and joints. This could be causing the stiffness and inability to extend your finger fully.

3. Joint Stiffness: After an injury, especially one that involves a puncture, the surrounding joint may become stiff due to disuse or inflammation. This stiffness can further complicate recovery and movement.

Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can provide exercises to improve range of motion, strengthen the muscles around the finger, and reduce stiffness. They may also use modalities like ultrasound or electrical stimulation to promote healing.

2. Splinting: Depending on the specific issue with your finger, a splint may be recommended to keep the finger in a position that promotes healing and prevents further injury. This can also help in gradually restoring function.

3. Scar Management: If scar tissue is a significant issue, treatments such as massage therapy, silicone gel sheets, or even corticosteroid injections may help reduce the thickness of the scar and improve mobility.

4. Surgical Intervention: If conservative treatments do not yield satisfactory results, surgical options may be considered. Surgery could involve releasing the tendon if it is adhesed, repairing any damaged tendons, or even removing scar tissue. The decision to proceed with surgery should be made in consultation with an orthopedic surgeon who specializes in hand injuries.

5. Joint Mobilization: In some cases, a hand therapist may use joint mobilization techniques to help restore movement in the affected joints.

Next Steps
1. Consult an Orthopedic Specialist: Given the complexity of your injury, it would be wise to consult with an orthopedic surgeon who specializes in hand injuries. They can perform a thorough evaluation, possibly including imaging studies like an MRI, to assess the extent of the damage and determine the best course of action.

2. Follow-Up Care: If you decide to pursue surgery, ensure you have a comprehensive rehabilitation plan post-surgery to maximize recovery and restore function.

3. Patience and Persistence: Recovery from finger injuries can be slow, and it often requires patience and consistent effort in rehabilitation.
In summary, while surgical intervention may be an option, it is essential to explore conservative treatments first, particularly physical therapy and scar management. Consulting with a specialist will provide you with a clearer understanding of your options and help you make an informed decision about your treatment plan.

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