Why Can't My Friend Straighten His Ring and Pinky Fingers After Surgery?

The ring finger and little finger cannot be straightened?

I have a friend who had surgery on his right hand due to an injury, which has resulted in his ring finger and little finger being unable to straighten.
Applying external force to straighten them causes pain.
Can you explain why this is happening and what rehabilitation steps should be taken afterward? Please help me, doctor.

Ye, 10~19 year old female. Ask Date: 2001/07/29

Dr. Pan Yingda reply Rehabilitation

The message is not very clear, but I will do my best to answer:
1.
What type of injury required surgery?
a.
Fracture?
b.
Laceration? Resulting in tendon or nerve rupture? How long has it been?
a.
A simple fracture is easier to manage; it typically heals in about one and a half to two months.
The approach is to avoid excessive movement at the fracture site to ensure proper healing, while also promoting joint mobility, stretching, and strength training.
b.
This is more complicated.
Is there any ability to straighten the limb? Yes, but it cannot be fully straightened, which is often due to tendon or joint impingement.
This may be a result of prolonged inactivity or the formation of scar tissue causing adhesions.
Attempting to forcefully straighten it can be painful, and if the pain is not originating from the injury site, joint mobilization is still necessary.
If there is no ability to straighten the limb at all, this indicates a more serious issue, possibly complete nerve or tendon injury, and it is advisable to consult an orthopedic surgeon promptly.
There are many potential issues, so it is best to see a doctor nearby.
Take care!

Reply Date: 2001/07/29

More Info

The inability to straighten the ring and pinky fingers after surgery can be attributed to several factors, including the nature of the injury, the surgical procedure performed, and the subsequent healing process. In your friend's case, it is likely that the surgery involved either the repair of tendons, ligaments, or bones in the fingers, which can lead to stiffness and reduced range of motion if not properly rehabilitated.

One common condition that could result from such an injury is called "joint stiffness" or "frozen finger," which occurs when the joints and surrounding tissues become tight and less flexible. This can happen due to scar tissue formation after surgery, which can restrict movement. Additionally, if the fingers were immobilized for an extended period during recovery, this can lead to muscle atrophy and joint stiffness, making it difficult to regain full function.

Another potential issue could be related to the tendons that control finger movement. If the tendons were damaged during the injury or if there was a complication during surgery, this could result in an inability to extend the fingers fully. In some cases, a condition known as "mallet finger" can occur, where the tendon that straightens the finger is ruptured or avulsed, leading to a permanent flexed position unless treated appropriately.

To address your friend's situation, it is crucial to follow a structured rehabilitation program. Here are some steps that can be taken:
1. Consultation with a Hand Specialist: Your friend should see a hand surgeon or a specialist who can evaluate the specific nature of the injury and the surgery performed. They can assess the range of motion and determine if there are any underlying issues that need to be addressed.

2. Physical Therapy: Engaging in physical therapy is essential for regaining movement and strength in the fingers. A physical therapist can design a personalized rehabilitation program that includes stretching and strengthening exercises tailored to your friend's needs. They may also use modalities such as ultrasound or electrical stimulation to promote healing.

3. Gradual Mobilization: It is important to start with gentle range-of-motion exercises to avoid further injury. Your friend should gradually increase the intensity and complexity of the exercises as tolerated. The therapist may also use splints or braces to support the fingers during the healing process.

4. Pain Management: If your friend experiences pain while trying to straighten the fingers, it may be beneficial to discuss pain management options with their healthcare provider. This could include over-the-counter pain relievers or prescribed medications.

5. Scar Tissue Management: Techniques such as massage therapy or the use of silicone gel sheets can help reduce scar tissue formation and improve mobility.

6. Surgical Intervention: In some cases, if conservative measures do not yield satisfactory results, surgical intervention may be necessary to release tight tendons or remove scar tissue that is limiting movement.

7. Patience and Consistency: Recovery from finger surgery can take time, and it is important for your friend to remain patient and consistent with their rehabilitation efforts. Regular follow-ups with the healthcare provider will help monitor progress and make necessary adjustments to the treatment plan.

In conclusion, the inability to straighten the ring and pinky fingers after surgery can stem from various factors, including joint stiffness, tendon issues, or scar tissue formation. A comprehensive rehabilitation program, guided by healthcare professionals, is essential for regaining function and improving the quality of life. Encourage your friend to seek professional help and stay committed to their recovery journey.

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