What Type of Finger Injury Is It? An introductory Guide for Patients

Hands endure a lot. More than 900,000 workers sustained a workplace injury in 2018. More than 120,000 workers injured their hands, making hand injuries the second most common form of injury.

A hand injury is often a finger injury. Fingers are small yet packed with tissues that become damaged. It can be hard to tell what type of injury you have.

What are the most common injuries, and what are their signs? What are injuries that require medical intervention? What can you do to treat yourself at home?

Answer these questions and you can keep a finger injury from derailing your day. Here is your comprehensive guide.

Bruises

Bruises are the most common finger injury. It is an acute injury that results when a person takes a direct blow to the skin and muscles.

Blood vessels leak blood, but the skin does not break. This discolors the skin, causing it to appear red, purple, or yellow.

A person may experience pain, swelling, and tenderness. But bruises will heal with time.

A serious bruise may require some ice to soothe. An individual should not poke their bruise, as they can cause blood vessels to break again.

Bruises are also called “contusions.” This is the medical term for bruises, and it does not refer to a separate or specialized condition.

Abrasions

The skin is made of several layers, with the highest layer being the epidermis. The epidermis can scrape against a surface, uprooting some cells. This is called abrasion.

A person may experience minor pain and discomfort, especially if they scrape their joint. They may bleed a little, but blood loss is rarely extensive. The skin may become red, and bruising accompanies some abrasions.

A person can apply pressure to their abrasion to stop any bleeding. If the bleeding continues, they can put a band-aid over their injury.

Cuts

Cuts come in two categories. Scratches are superficial cuts that damage the outer layers of skin. They can occur when fingernails or a sharp object pokes someone’s finger.

Because they break the skin, they can result in bleeding. But scratches do not lead to significant blood loss or infection. As with abrasions, you should apply pressure to the cut and put on a bandage.

Lacerations go to different depths of the skin or dermis, and can go through the entire depth of skin. They usually occur when a person cuts themselves with a sharp object such as a knife, or blunt injury.

Not all lacerations require sutures.  Some indications that a wound may need sutures are its: location on the finger, the length, and what other structures may be exposed without suturing.

Nail Bed Lacerations / Injuries

The nail bed lies directly beneath the nail plate. It contains a few layers of skin to provide support to the nail.

As with other parts of the skin, these layers can become cut. Resolving these cuts is not as simple as resolving cuts elsewhere on the finger.

Many people experience a subungual hematoma after cutting their nail bed. Blood collects beneath the fingernail, akin to a bruise. But a hematoma induces a great deal of pain and impairs the use of the finger.   Some hematomas require doctors to drain them. They will drill or make a hole through the nail and let the blood flow out. It is always best to have a specialist evaluate the subungual hematoma to determine if it needs to be immediately drained, left alone, or the whole nail needs to be removed and the damage to the nail plate and bone repaired.  In general subunquinal hematomas encompassing less than half the nail can be left alone.

Some lacerations require stitches in order to close. The fingernail itself may become broken, which can take time to heal.

Many people experience hangnails. A tiny and damaged piece of skin crops up on the edge of a nail bed. But most hangnails happen due to dry skin or infections, not injuries.

Ligament Damage

Ligaments are important connective tissues. Some connect two bones or cartilages together. Others hold joints together, allowing them to move.

A person can sustain several ligament injuries in their fingers. Sprains are among the most common ones. They occur when ligaments get torn or overstretched.

Sprains are common in contact sports, but they are an overuse injury. Reaching upward over and over again can overextend a ligament in the finger.

There are several important ligaments of the fingers, including collateral ligaments which holds the sides of the fingers and stabilizes them and the volar plate, which is on the bottom side of the joint.  On the thumb:  The thumb metacarpophalangeal joint connects the thumb to the hand. It contains two ligaments (ulnar collateral ligament and radial collateral ligament) that prevent the thumb from pointing away from the hand. When one or both of the ligament tears and the thumb becomes injured to the point it is ruptured, a person has a “gamekeeper’s thumb” or “skier’s thumb.”

Ligament damage can be painful, creating stiffness and muscle weakness. A person may have pain with movement of their finger or have weakness with pinching of the thumb.

Depending on the type of injury a person may need to wear a splint or massage their fingers. Ligament injuries do not always require surgery or extensive physical therapy. Some can heal on their own.

Tendon Damage / Injury

When someone tries to grab a shirt or jersey, and the sheer force pulls the tendon and bone from the very last digit, you can have a loss of flexion or bending of that joint.  The flexor tendon pulls a finger toward the palm.  This is a condition called “jersey finger.”

Muscle Strains

Strains are similar to sprains, in that they involve overstretched tissue. But strains occur in the muscles, while sprains occur in ligaments.

Most strains that impact the fingers occur in tendons. Tendons connect muscles in the arms to finger bones.

A tendon may not be torn in the finger, but a tear will cause pain there. Pain becomes prominent when a person tries to move or apply pressure to their hand.

Many people sustain strains during exercise. They can also come from typing at a keyboard or using small objects like pens over several hours.

Strains are treated identically to sprains. Someone should rest their strained finger and apply some ice to it.

Dislocations

A joint connects two bones together, allowing a finger to bend. If the two bones become misaligned at the joint, a dislocation occurs.

The thumb has two joints, while each of the other fingers has three. Any joint can become dislocated, though the middle joint of the finger gets dislocated most often.

Dislocations result from collisions. Running into someone or falling onto a surface are common causes. Dislocations can have genetic components, as some people are born with naturally weak joints.

The joint and injured finger will appear crooked. A person will encounter moderate pain, but the pain can worsen if they try to use their finger. Swelling can occur in the joint, making the pain worse.

A dislocation requires a doctor’s intervention. They will pull the bone back into its socket, which can cause some discomfort. A person may experience swelling or stiffness for a few months.

Fractures

Fractures occur when a bone breaks or cracks. Nearly all fractures are impact injuries, though a person can have naturally weak bones. Some infections and tumors can cause fractures, though these are rare.

A fracture will induce significant pain. If a bone breaks completely, the finger can become deformed in odd angles. The finger may swell, bruise, and become difficult to move.

The symptoms of a fracture overlap with dislocations and tendon injuries. A person who thinks they may have broken their finger should go to their doctor. The doctor will use an x-ray to see where the fracture is and evaluate treatment.

Cracks and minor fractures do not require extensive care. An individual may need to wear a splint and get some rest.

If the finger is bent out of position, a doctor can correct it. They inject anesthesia into the finger, then manipulate the fracture so the bones rest evenly on each other.

Significant fractures can lead to surgery. A doctor may also recommend surgery if a fracture is not healing correctly. Surgeons can attach pins and screws to hold the fracture where it should be.

Bites

Animal bites are significant injuries. A bite can break the skin and bone, and it can cause damage to muscles and joints.

Animals have a lot of bacteria and viruses in their mouth. A bite can send the bacteria into the bloodstream, causing a dangerous infection.

Anyone who gets bitten by an animal should go to the emergency room. If possible, they should contain the animal so it can get tested. It may have rabies, which a person should receive immediate treatment for.

Human bites are also dangerous. Many people injure their fingers when they punch someone’s mouth or reach into the mouth.

Human saliva contains a range of germs, so a bite requires medical intervention. A doctor should clean the injury, and the victim should take antibiotics.

Carpal Tunnel Syndrome

The carpel tunnel is a passageway that contains tendons and nerves, allowing them to enter the fingers. The tunnel is narrow, and it can become constricted due to swelling and stress. If it narrows too much, it can pinch the nerve and cause carpal tunnel syndrome.

The syndrome is a very common overuse injury. Many people who work at a desk receive it because they put pressure on their wrists and fingers. Typing on a keyboard or handwriting notes are prominent causes.

A person may experience pain that radiates from their wrists into their fingers. It may become severe at night, waking them up. It may become difficult to grip objects or move the hands and fingers.   Sometimes the numbness can be so severe, patients can burn their fingertips and not even know it.  So if you find unexplained burns on your fingertips, you may have advanced carpal tunnel syndrome, and not even know it.

Carpal tunnel syndrome is debilitating and requires treatment. Some people may need to rest for a prolonged period of time, reducing their swelling.

Others may need intervention to release pressure on their carpal tunnel. A surgeon can cut through the ligament, making room for the nerve and tendons.

This procedure requires stitching to close. But doctors have developed a No Stitch procedure.

They apply an anesthetic, then they release pressure through a small cut in the ligament. The wounds heal quickly under bandages, without the need for stitches.

Tendonitis

Inflammation can affect any muscle, including the tendons. Tendon inflammation in the hands is called hand tendonitis.

The tendons can become strained from overuse and repetitive motions. Conditions like arthritis and diabetes can make a person more susceptible to inflammation in the fingers.

Tendonitis is reminiscent of sprains and strains. It can induce pain, tenderness, and muscle weakness.

But it is a more significant condition. People with tendonitis struggle to hold small objects, especially pens and keys.

Most cases are resolved through physical therapy and minor measures. Anti-inflammatory medications like aspirin bring pain and swelling down. A doctor can provide cortisone shots, which can speed the healing process up.

Gentle stretches keep the muscles active, preventing cramps. Some people may need more extensive physical therapy in order to restore mobility.

Crushing Injuries

Crushing injuries can be extensive. Getting a finger caught in a door or striking it with a hammer can cause fractures and infections.  Often times we see a lot of work related crush injuries to the fingers.  Crushing injuries can cause damage to several structures of the finger – soft tissue (skin and fat), bone, nerves, arteries, and nail.  They can often be complex, and need surgery either immediately or as soon as possible.  All aspects of the injury need to be evaluated and addressed.    Quite often patients with crushing injuries may have long term issues of pain and swelling.

Mallet Finger

A mallet finger occurs when the tip of the finger gets injured. This usually happens when someone jams their finger into a door or has some other type of trauma / injury.    A mallet finger is a complex injury to extensor tendon at the tip of the finger.  The extensor tendon  stretches and sometimes  a piece of bone breaks off with the tendon.   With the injury, you will see the last joint hang down, and you cannot straighten it out.   Depending on the involvement of the bone, mallet fingers can heal without surgery, but sometimes will need surgery.   An evaluation is necessary to make that determination.

Finger Amputation

A person can amputate their finger. This is a medical emergency. The finger can be reattached if the extent of the injury is not severe.  Patients are usually referred to a trauma center, where a team of doctors are usually prepared to handle these types of injuries.

Less severe injuries such as finger tip injuries can be either reattached, or tissue from other fingers or the palm can be used to help cover the loss of skin.  Other issues may have to be addressed.

What You Should Know About a Finger Injury

A finger injury can be anything. Thankfully, most injuries require no or little care. Bruises, abrasions, and cuts require some ice and possibly a bandage.

You should rest your finger if you suffer from ligament damage or muscle strains. You will encounter stiffness and pain.

Dislocations and fractures are painful and deforming. You should go to a doctor for them. Bites and amputations are medical emergencies that require paramedics and extensive cleaning.

Find someone who specializes in finger care. The Hand Surgery Specialists of Texas serves the Houston area. Make an appointment today.

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