long mountain run yesterday. very cool run. saw a mama bear with her 2 baby cubs. priceless.
but, took a fall on the way back, middle finger pointing in the wrong direction at the middle joint. popped it back into place. but, very swollen, skin very tight today. got a little cut on it as well when i went down. much chance this is from an infection from that little cut? or is my finger likely to be this swollen and stiff from just the dislocation?
Depends on the depth of the cut. More than likely it is from the dislocation. Swelling and some inflammation would be common. Good luck.
Hi Dan-- urgent care doc here. a tendon attaches on both sides of the phalanges (bones in your finger) and when the bone is pulled to one side, the tendon can pull off a small chunk of bone away (called an avulsion fracture). An xray would show this. If you end up having an avulsion injury, you would still be able to flex/extend (move your finger) since you still have a tendon attached on the other side. I say this when my patients say “well, it can’t be broken, because I can move it”. I think an xray would be nice. You will baby this finger and be more careful if you know there is a break. All you would need is an aluminum finger splint, one that is removable/reusable. I think 1 day is too early to develop cellulitis (bacterial infection). If your tetanus vaccine isnt updated, you should get one. 2 ibuprofen a few times a day will help with swelling too, and ice. See your local urgent care doc?
thank you. can i just tape it to the adjacent finger, as i would with a toe? i’m going swimming in a little while, and that was my intended fix for today.
That is what I would do as well. With the splint being used throughout the rest of the day.
Can we see a picture of it?
Were these guys the little buggars?
that’s about what they looked like, except both mom and babies were a bit lighter. if you google black bear cinnamon, that’s what i saw. i don’t know if this is typical of the mountains where i live. i only saw a bear up here once before and it was in the same exact area. same place. don’t know if it was the same bear.
i’m on a roll. my first mountain lion sighting in the wild and now these little critters.
I would echo shacking’s suggestion for an x-ray. PIP (proximal inter-phalangeal) dislocations are usually benign, and once reduced are usually treated with a malleable aluminum splint. Buddy taping is fine in a pinch but can result in skin maceration where there’s contact. Swelling is expected but can hide a subluxed joint. A volar plate injury can cause complications including interposition and chronic pain/swelling. An avulsion injury is indeed a concern (ligament, though, not tendon) and can cause chronic instability.
A random laceration about the injured finger is unlikely to cause infection, but if the laceration is related to the dislocation, there may be communication with the joint…this needs attention such as antibiotics and potentially surgical debridement (again, unlikely). Of course, I’d refer you to one of my two hand surgeon partners since my specialty is hips and knees :-). Good luck…I"m sure it’ll be fine. Rick
thanks. always nice to keep tabs on hips/knees guys 
i guess i should’ve pinged my surgeon. he does collarbones as a sub-specialty, because he’s the doctor for ATOC and ends up doing everybody’s collarbones in the peloton. but he’s a hand specialist.
i just don’t like to bother people with my troubles. except for you all.
Ping him…he’ll probably appreciate a true hand injury. And I’m pretty sure that you use that finger when you type, so we all have a personal stake in this particular injury :-).
Pictures or it didn’t happen!
well, okay, it isn’t THAT swollen.
i have to tell you, when i looked down at my hand, just as in that picture above, and my middle finger was pointing more or less at my face (or at least angled up in that direction) that was kinda freaky.
it’s a little bit more swollen now than it was this morning, when i took that pic, but not a lot more so. i’m just lucky it wasn’t the ring finger because i’d have played hell getting that titanium/gold ring off.
Dan - you want to cognizant of one more possibility, a central slip disruption or boutonniere injury. The small tendon that inserts into the top of the middle digit ruptures but is frequently missed unless the practitioner is specifically looking for it. Better treated early than late. If the person who evaluates you does a lot of hand work, they will do an Elson test on your finger to ascertain the presence/absence of this injury.
Best of luck.
John
rub some dirt on it nancy
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thanks. question for you doctors. i hate to run to the doctor for every little thing. this is going to be big money before it’s done (high deductible plan). i’ll be in this thing a couple of thousand bucks. and a couple of days off of work, because my guy is 2hr away. imaging. the radiologist is going to do an MRI of my finger, and if there’s such a thing as a 24hr holter for the finger, read by a specialty computer, i’ll probably have to have one.
i would like to keep the finger. i would like to keep the thing the finger is attached to. beyond that, how bad can this eventually be if “left untreated?” mind, i’m typing with it right now. yes, if it hits something it hurts like hell. but i just did this yesterday. is there some kinda, like, wait 3 or 4 days, see if it starts to feel better type thing?
i don’t plan on sticking this finger anywhere it shouldn’t go for the next few days anyway. so, what would you do? if it was your finger? and your radiologist didn’t owe you a solid?
Dan -I can’t tell you the standard in your area, but it sure wouldn’t include an MRI at this medical center!
Step One: establish an accurate diagnosis through taking a history, performing a physical exam and probably obtaining plain x-rays. Order special tests if needed should the diagnosis be in doubt. (No Holters on digital injuries!) Establish a treatment plan.
I don’t know where you live but any hand guy/gal can do this in 15 minutes for nowhere near $2K.
How else may I be of assistance my lord?
John
that’s down-to-earth advice, by cracky. puts it in proper perspective. thanks.
I had that happen. But not a fall. But from jabbing a finger into hard plastic lane lines at the pool while circle swimming. Like the Doc said, I got an aluminum finger splint from a pharmacy, with a Velcro strap to tighten it over the finger, and put it on myself. Finger was kind of sore and tight for months after but it fully healed to 100% eventually.
Welcome.
A little follow up would be nice if it’s something; you’d care to share. PM would be fine.
Good luck, hope it’s something little.
John