Injuries to the fingertips are common in accidents at home, work, and play. They can occur when the fingertip slams in a car door, chopping vegetables, or when clearing debris from a lawnmower or snow blower. In the case of a fingertip amputation, gently clean the amputated part with water (preferably saline), cover it in a gauze wrap, put it in a watertight bag and place the bag on ice. Do not put the amputated part directly in ice as this could further damage it. The goal of treatment is to replant the finger if feasible.
FRACTURE – PHALANX (FINGER)
Phalanx Fractures are fractures of the small bones of the fingers. Finger fractures may result from a twisting injury, a fall, a crush injury, or direct contact in sports. Symptoms may include swelling, tenderness, deformity, inability to move finger, shortened finger, and/or a finger crossing over its neighbor. The goal of treatment is to realign the bone so that proper healing can take place. Depending on the alignment of the break, your surgeon may or may not recommend surgery. Usually after realigning the finger bone, a splint can be placed to keep it in position for healing.
Ganglion cysts are very common lumps within the hand and wrist that occur adjacent to joints or tendons (cords that connect muscle to bone). The most common locations are the top of the wrist, palm side of the wrist, base of the finger on the palm side, and top of the end joint of the finger. It often resembles a water balloon on a stalk, and is filled with clear fluid or gel. These cysts can often be observed or removed if causing pain.
Jersey finger is titled because this injury occurs in American Football when a player grabs an opponent player’s jersey while the opponent is trying to get away from him. Doing this causes the tip of the finger to extend beyond its normal range, while the rest of the finger is in flexion. This causes the tendon that attaches the finger muscle to the tip of the finger to pull off, or avulse. This results in a fingertip that can no longer flex or bend. Symptoms include a pop or rip sensation in the finger at the time of injury, pain when moving the injured finger and the inability to bend the last finger joint. Tenderness, swelling, warmth, bruising after 48 hours, and an occasional lump is felt in the palm of the finger. The goal of treatment is to repair the pulled off tendon back to the fingertip bone.
MALLET FINGER (BASEBALL FINGER)
A mallet finger is a deformity of the fingertip that is caused when a tendon (a cord that connects muscle to bone) is damaged. The tendon damaged is the extensor tendon located on the back of the finger that is responsible for making the fingertip point straight out. When a ball or another object strikes the tip of the finger, the force damages this tendon and may even pull a piece of bone off along with the tendon. When this occurs, the finger is not able to straighten. The condition is also known as baseball finger. Symptoms include pain, swelling, and bruising of the finger. A finger droop may be noticeable. The goal of treatment is to keep the finger straight with a splint so that the tendon can heal. Although splinting may help gain an acceptable fingertip appearance, many patients may still not regain full fingertip extension.
FLEXOR TENOSYNOVITIS (TRIGGER FINGER)
Trigger finger limits finger movement. When trying to straighten your finger, it will lock or catch before popping out straight. This is caused when the flexor tendon (the cord that connects the muscle to bone) becomes irritated as it slides through the tendon sheath tunnel (or finger pulley). As the tendon becomes more and more irritated, it may thicken and nodules may form, making its passage through the tunnel more difficult. The tendon sheath may also thicken, causing the tunnel opening to become smaller. Symptoms include a tender lump in your palm, swelling, a catching or popping sensation, and/or pain when bending or straightening your finger. The stiffness and catching tend to be worse with inactivity, such as when you first wake up in the morning. The goal of treatment is to reduce inflammation and return finger function and range of motion. The doctors at the hand institute are currently performing a state of the art procedure, offering a quick and painless technique in the office to treat trigger finger.
CARPOMETACARPAL ARTHRITIS (BASAL JOINT ARTHRITIS)
Carpo- refers to you wrist bones and –metacarpal refers to the long bone between your wrist bones and thumb bones. The joint between these two bones is called the carpometacarpal joint. With age, arthritis may develop at this joint. Thumb arthritis occurs when the cushioning cartilage at the joining ends of these two bones wears away. This may result in pain, swelling, decreased strength and range of motion, making it difficult to do simple activities of daily living. The goal of treatment is to relieve pain and reduce inflammation. Depending on the severity of the arthritis, your doctor may recommend surgery.
DE QUERVAIN’S TENDINITIS
De Quervain tendinitis occurs when the tendons around the base of the thumb (where the thumb meets the wrist bones) are irritated or constricted. The word “tendinitis” refers to swelling of the tendons. Symptoms include pain, swelling, and tenderness along the thumb side of the wrist. The pain is particularly noticeable when forming a fist, grasping or gripping things, or when turning the wrist. The goal of treatment is to relieve the pain caused by irritation and swelling.
COLLATERAL LIGAMENT INJURY (GAMEKEEPER’S OR SKIER’S THUMB)
Ligaments are structures that attach bone to bone. In the thumb, the ulnar collateral ligament is found on the inside of your thumb knuckle connecting the two bones together. The injury occurs when there is an extreme force that pulls the thumb away from the palm of the hand. This can damage the ligament resulting in a tear (sprain) or rupture. Symptoms include pain, swelling and weakness of the thumb. The goal of treatment is to help the ligaments heal so that the thumb can be restored to full function.