Hand > Finger Injuries

What are Finger Injuries?

Finger injuries can encompass everything from a benign jamming injury or sprain to a dislocation to a severe fracture that occurs in multiple places and requires surgery. Each finger has three bones ­- the distal (fingertip), middle, and proximal phalanges. Like other joint structures in the body, fingers are stabilized by ligaments and tendons. When the finger receives a blow to the tip, the ligaments and tendons can be stretched and torn, and one or more of three joints can be injured: the distal interphalangeal (or DIP; the first knuckle), proximal interphalangeal (or PIP; the middle knuckle), and metacarpophalangeal (MCP; the knuckle at the base of the finger). The most vulnerable area is the PIP, or middle, joint. One of the reasons it is the most commonly injured area is that it is a little bit more exposed than the other joints and does not have much protection around it. The PIP joint also has a very large arc of motion, which means that the range of the joint is huge ­ it goes from full extension, or zero degrees, to well past 90. So it is a very high-demand joint and is required for all finger motion, from fine dexterity, like threading a needle, to catching a football.

Many finger injuries occur when an athlete falls on the hand or wrist, especially in basketball. Fingers are injured when the ball is caught the wrong way and it hits the finger end-on. Also, you can injure your fingers by jamming them on a piece of equipment or into another person's hand or shoulder.

If you are wearing a ring at the time of the injury, try to remove the ring before the joint becomes too swollen. You should always ice the injury and elevate it initially because that will help the swelling go down. But if after a short time those symptoms do not improve and your motion does not gradually get better, then you should have an X-ray. If the injury is a simple sprain, which means surgery and immobilization are not required, then the best thing to do is to remember that scar tissue can be your enemy. Therefore, you want to keep the finger moving as much as you can to reduce the formation of scar tissue. It is important to move the fingers as soon as you can to avoid long-term enlargement and inflexibility. You will do yourself a favor by not putting the finger in a splint or resting it for a prolonged period of time. Surgery is required in instances where the bone is displaced or broken and the position of the bone after it is broken indicates it will not heal properly on its own. If an injury does require surgery, usually it is put in a cast afterwards or immobilized with a splint. Most finger injuries, even those addressed surgically, should show significant improvement in four to eight weeks.

It is important to "buddy-tape" the injured finger to an uninjured finger next to it to help prevent re-injury. In the first few weeks, it is more vulnerable to injury because your finger positioning will not be exactly the same, your rapidity of motion will be different, and you will be inclined to bump it or bang it more often. It may be best not to play for a short time. Physical therapy may help you restore coordination and strength in your fingers after an injury. Unfortunately, athletes and competitors sometimes have to live with these injuries and endure things like swollen fingers and large knuckles for their entire lives.