Digital Trauma

Hands with finger sprain

Posted on 6/4/2019 by Victoria Trueba, MOT, OTR/L, CHT

 

Finger sprains are very common. They can cause torn ligaments and broken bones even if you don’t see an obvious deformity and are still moving your finger. Earlier treatment allows you to recover faster, identify a more serious injury to your finger and begin the most successful treatment. Whether it’s a basketball player who jammed his middle finger against the ball, an employee late to work who slammed the car door on her finger or a dog leash that became tangled and pulled on a finger, digital trauma is nothing to shake your finger at!Case in point: Mrs. F,  a teacher’s aide working with children with special needs. One particular morning as the class was completing an arts and craft project, Mrs. F went to help a student who was becoming increasingly upset. As she was attempting to help the student, he accidentally grabbed Mrs. F’s finger instead of the crayon. Without thought, Mrs. F pulled away and her middle finger got twisted. She recalls the intense pain and immediate swelling she experienced after the injury; however, she thought the pain would go away on its own and that ice would help with the swelling.As the days went on, Mrs. F’s middle finger was not improving. It remained swollen, tender to the touch and she noticed bending and straightening became more limited. Her grip had been affected, and daily tasks such as grabbing the steering wheel and writing became challenging. Mrs. F remembers thinking, “But it was just a finger sprain!”Our fingers contain three joints, with the most commonly sprained joint being the middle knuckle. Our joints also have many ligaments, which serve as a type of checks and balance system that allows both mobility and stability. When Mrs. F was finally evaluated by an orthopaedic physician four weeks after her injury took place, she was diagnosed with a grade 1 injury to a ligament on the side of her joint – the culprit of her limited mobility. Grade 1 ligament injury is detected when there is localized pain and tenderness over the involved joint, noticeable swelling and possible bruising.Depending on the grade of the strain, different treatment options are available. In Mrs. F’s case, a grade 1 injury is less severe on the scale of 1 to 3. As the severity increases to grade 2 and grade 3, the integrity of the ligament is further injured, which results in a less stable joint and a need for prolonged immobilization. In some cases, these injuries may require surgery.We were able to treat Mrs. F’s grade 1 injury with 7-10 days of immobilization in a custom removable splint for eight weeks. This allowed the swelling to go down and the ligament to begin healing. Afterward, she wore fabric buddy tapes around her index and middle fingers to protect the middle finger from a sideways force. Needless to say, don’t be fooled by a ‘simple’ finger injury! Although Mrs. F had a grade 1 injury, she was still significantly affected in her ability to complete daily activities. By the time she began therapy, she had lost a considerable amount of motion in her finger and had begun finding ways to grip without using her middle finger. Even a low grade strain may require therapy due to stiffness, weakness, swelling and hypersensitivity to touch. Make sure to have an injury evaluated in a timely manner and get the appropriate treatment to avoid deficits in doing the things you love most.

By: Victoria Trueba, MOT, OTR/L, CHT. Vicky is an occupational therapist and certified hand therapist with Select Physical Therapy in Trinity, FL.