Finger and Thumb: Injuries and Conditions
Hand and finger injuries are some of the most common injuries we all endure during our life times. It is important to not underestimate the severity of a finger injury as the improper treatment or lack of treatment compliance can result in a permanent disability and decreased hand function. Most finger injuries can be treated and managed by family practice physicians, however, depending on the physician’s comfort level and your preference, you may be referred to a hand surgeon for further evaluation and treatment.
Finger injuries fall into two categories: acute and chronic. Acute injuries are considered those that have occurred as a result of a recent traumatic event. In contrast, a chronic injury is the result of overuse or an unresolved acute condition. The most common chronic conditions are scaphoid non-union, arthritis, tendonitis and bursitis. Some of the most common acute finger injuries include the following:
Finger injuries fall into two categories: acute and chronic. Acute injuries are considered those that have occurred as a result of a recent traumatic event. In contrast, a chronic injury is the result of overuse or an unresolved acute condition. The most common chronic conditions are scaphoid non-union, arthritis, tendonitis and bursitis. Some of the most common acute finger injuries include the following:
- Mallet Finger or Baseball Finger - This injury involves the extensor tendon between the second (PIP joint) and third phalangeal joints (DIP joint). The extensor tendon may be stretched, partially torn, or fully ruptured by a distal phalanx avulsion fracture. The cause of injury is usually an object striking the fully extended finger and causing forceful flexion of the DIP joint.
- Jersey Finger - This injury involves the flexor digitorum profundus tendon when there is a forced extension of the DIP joint during active flexion. It most commonly occurs when an athlete’s finger catches on another player’s clothing while playing a tackling sport such as football. The ring finger injury accounts for majority of jersey finger cases.
- Jammed Finger - Forced side-to-side deviation at any of the IP joints can cause partial or complete collateral ligament tears. The collateral ligament can tear at one of two locations, (1) at its attachment to the proximal phalanx or (2) at its attachment to the volar plate and middle phalanx. The PIP joint usually is involved in collateral ligament injuries, which are commonly classified as a jammed finger injuries.
- Central slip extensor tendon injury - This is a common finger injury in basketball players. It occurs when the PIP joint is forcibly flexed while actively extended. Another cause of the central slip ruptures is the volar dislocation of the PIP joint. In either case, if the injury is not treated in a timely fashion, the affected finger will develop a Boutonniere deformity.
- Volar Plate Injury - Hyperextension of a finger joint, such as a dorsal dislocation, can injure the volar plate, a thick ligament on the palm side of a finger joint. The PIP joint usually is affected, and collateral ligament damage often is present. The volar plate can be partially or completely torn, with or without an avulsion fracture. The subsequent loss of joint stability may allow the extensor tendon to gradually pull the joint into hyperextension, causing deformity.
- Finger Dislocation - The PIP finger joint is the most frequently dislocated joint and if not evaluated at treated in a timely fashion, long-term pain, stiffness, and deformity develop.
- Finger Fracture - Finger fractures can occur in the phalanges or the metacarpal bones. Boxer's fracture at the neck of the fifth metacarpal bone is the most common metacarpal bone fracture.