Straight, No Chaser: Broken Fingers

brokenfinger

Don’t the tips of your fingers drive you nuts? Our leading edges cause so much drama for us. We’ve previously discussed injuries to nails and nail beds, but many of you who work with your hands know all too well that lacerations and broken bones may be a consequence of a crush injury, a fall, a power saw or some other means of injury. Interestingly (at least medically), finger fractures have a multitude of appearances. Simple-appearing injuries may disguise complicated underlying injuries, and complicated-appearing cuts may reveal the full extent of the injury. For your purposes, you should always get significant injuries (and certainly any injuries potentially complicated by a fracture) evaluated. Healing in this area can be very difficult given its remote location from the body, and given all the various functions of your fingers (ranging from touching, scratching, eating, typing, tying your shoes), appropriate evaluation, diagnosis and treatment are a must.

Your clues are pretty obvious. Look for pain when touching the finger (especially deep bony pain), swelling, difficulty bending (which is different than pain when bending) and/or deformity to the finger. Our clues are pretty obvious, too. That’s why we obtain x-rays!

It bears repeating. Your fingers are your body’s “stalking horses” and serve the purpose of interacting with our environment. A broken finger that goes unaddressed or gets mismanaged can lead to a life-long deformity and inability to perform many of the activities of daily living. As such, here are the types of considerations your emergency physician is looking for when determining whether or not your finger is broken.

Fracture_Finger_Open

  • Is a joint involved? Your joints allow for movement of different parts of your finger, as these are the areas where different bones meet. A fracture involving the joints is more likely to produce deformity unless addressed.
  • Is the fracture so “smashed up” that it is defined as “unstable?” An unstable fracture requires emergency orthopedic intervention to reapproximate the structure and positioning of the bone that allow for adequate function. Otherwise, the bones may further shift out of position, leading to additional loss of function.
  • Is the finger deformed? We look for abnormalities such as rotation, angulation and shortening of the broken finger fragments. These deformities may produce functional losses and sometimes require surgery to repair.
  • A special consideration that will be discussed in a separate Straight, No Chaser is the fracture that is accompanied by a laceration or other loss of skin tissue. This is called an open fracture.

 fingerbuddytape

You’ve probably seen variations of treatments, ranging from the metal finger splints and the “buddy taping,” in which the broken finger is wrapped to the adjacent finger (as noted above). These procedures are adequate for simple fractures without any of the above considerations. More complicated fractures may require placement of surgical pins, plates or screws to hold the bones in place while healing occurs. Your bottom line is to remember how important your fingers are. If and when they get injured, get them evaluated so you can keep functioning as your normal self.

An injured man's finger in a splint.

 

Feel free to ask your SMA expert consultant any questions you may have on this topic.

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