One of the most common joint fractures of the fingers is the fracture of the knuckles, i.e. the junction between the bones of the palm and the fingers.
This joint is most often injured during activities in which the hand is clenched into a fist; a fracture at this point is also called a boxer fracture because it occurs during a punch.
Signs and symptoms
Finger fractures immediately cause pain, swelling, bruising and sometimes a malposition of the finger bones.
In the case of strong force, a finger dislocation (dislocation) can also occur, i.e. the joint-forming bone ends suffer a loss of contact.
If there is no obvious deformation, the affected fingers cause great pain.
A fracture may be present even if the finger can still be moved; the ability to move depends on the severity of the injury.
Depending on stability, some fractures can cause more discomfort than others.
As a rule, within 5 – 10 minutes after the accident, a swollen finger and bruise become noticeable, the finger becomes stiff and flexion becomes problematic.
The swelling is not as specific as the pain, the adjacent fingers can also be affected.
In the case of a serious bone fracture, the bruise is immediately visible.
With severe swelling, the finger can fall asleep because the excess fluid presses on the nerves.
Therapy of a finger injury
In the case of a broken finger, immediate measures such as splinting and protection help.
Ice pads and a high position of the hand (above the heart) help to relieve bleeding and swelling.
Then a doctor should be consulted immediately.
An X-ray is definitely necessary to confirm the suspicion of bone fracture and to determine whether the bone pieces are displaced (dislocated fracture).
In the case of a displaced fracture or a fracture with several bone fragments, surgical treatment may be necessary.
In surgical intervention, a screw is inserted that holds the fragments together until healing has occurred.
Finger dislocation or finger dislocation is a fairly common sports injury in which the connective tissue surrounding and stabilizing the finger joint ruptures.
For this reason, the joint-forming bones shift, a malposition can be observed and the finger cannot be moved.
A dislocation of the finger often happens in ball sports that involve hitting and intercepting the ball, such as basketball and volleyball.
Most often, the affected finger is spread to the side or backwards during the accident.
A direct blow to the finger hardly leads to a dislocation.
A finger dislocation can also occur in contact sports when colliding with an opponent or in martial arts.
Signs and symptoms of a dislocated finger
Patients with a finger dislocation feel a sudden and intense pain in the finger.
Often a malposition or step formation is visible as a result of the displacement of a finger bone.
At the moment of the accident, a cracking noise can be heard.
The pain may be in the front, back or on the sides of the affected finger joint.
In rare cases, pain and tingling occur all over the finger or hand.
The swelling can occur immediately or it develops gradually over the course of several hours.
Treatment of a dislocated finger
First, an X-ray must be taken so that accompanying bone fractures can be detected.
An existing bone injury is particularly important if the finger dislocation was caused by violent force.
Before the doctor relocates the finger, he must know whether there is a bone fracture so that it does not cause further damage.
So first an X-ray, then the fastest possible reposition of the bone, which must be carried out by an experienced orthopedist or sports physician.
The patient should never try to set up the bones himself, because he could injure nerves and blood vessels.
If the X-ray image shows a bone fracture, surgery may be necessary.
After dislocation, a dislocated finger heals well in most cases if appropriate physiotherapy treatment is provided.
Tear of the finger flexor tendons
A cut can cause injury to flexor tendons and nerves.
Sports accidents, especially in football, wrestling or rugby, are the main cause of a flexor tendon lesion.
In patients with rheumatoid arthritis, spontaneous rupture of the finger tendons may occur.
pain above the finger flexors.
The patient is not able to bend one or more finger joints, even the attempt is painful.
Injuries to the flexor tendons must be treated as quickly as possible, within 2 -3 weeks after the accident.
If you wait more than a month with the operation, there is a risk that muscle and tendon will retract and lose their elasticity; It then becomes difficult for the surgeon to join the ends together and additional measures may be necessary, such as tendon plasty by an interpose.
The recovery time until the resumption of everyday activities is about two months.
Tear of the finger extensor tendons
The extensor vision is very susceptible to injury, here even a smaller incision is sufficient. Violent force can lead to a tearing of the tendon at the base of the bone (avulsion).
Signs and symptoms
A rupture of the finger extensor tendon can cause a hammer finger, i.e. the permanent flexion position of the finger end joint (distal interphalangeal joint), or a buttonhole deformity, the permanent flexion position of the middle finger joint (proximal interphalangeal joint).
If the extensor tendons are severed by incisions in the back of the hand, the stretching of the finger with respect to the metacarpal (metacarpus) may be made impossible.
In case of incomplete tears of the extensor tendons, the doctor applies a finger splint.
In the case of a complete rupture, the tendon ends are reunited as part of an operation.
If there is a considerable restriction of finger movement, the scar tissue may have to be surgically removed.
A bruise or contusion occurs when subjected to force by a blunt object, in which no skin injuries occur, but a bruise in the soft tissue of the hand.
In the accident, blood vessels of the hand and fingers are injured; the accumulated blood leads to the formation of bruises, even if tendons, muscles and bones remain undamaged.
A bruise can result from an explosion, sprain or fracture.
The entire upper limb should be examined.
The following aspects must be taken into account when making a diagnosis:
- Color changes
- Surgical and non-surgical scars
- Asymmetry of the hands
- Misstealing that indicates a dislocation
- Differences in the bending/stretching movement of the relaxed hand: the relaxed hand is slightly bent.
- The fingers of both hands must have approximately the same degree of flexion.
Usually, the little finger is more bent than the others; if a clear difference in flexion is visible, the examiner must suspect a tendon injury.
A loss of sensitivity of the skin indicates a nerve injury.
A depression above the ball of the thumb is a sign of the dislocation of the thumb joint.
The range of motion of the shoulder, elbow and all joints of the hand must be controlled. It should also be checked whether the active and passive rotation of the forearm (pronation and supination) is possible.
The force during the handshake and the thumb-index finger “pliers” must be checked.
Treatment of finger injury
- Ice pack (wrapped in a cloth) to stop bleeding and decongestion, even better is the immersion of the hand in a bowl of cold water (about 15 °).
- If there is no container, the fingers can also be held under a running tap.
- To relieve bleeding and swelling:
- apply pressure bandage,
- Elevation of the hand above the heart.
An improvement of the symptoms usually occurs after 2-3 days.
Otherwise, a doctor should be consulted.
The orthopedist may order an X-ray examination to determine if there are fractures.