You jab your finger into a wall, catch a ball wrong, fall on the finger, inadvertently run into someone - jammed fingers result from many causes. However you do it, the results are the same: a painful, swollen, stiff finger. It is probably a sprain, a stretching or partial tearing of the ligaments and capsule surrounding the joint. Finger joints are small, and they seem to stay swollen forever after they've been injured. Jammed fingers stay swollen for months, even if they are not very serious, and there is not a lot you can do about it.
A swollen finger won't bend as far as a normal one, so people develop the habit of making it bend by pulling at it with the other hand. That irritates it more and makes it swell further. Months later they may wonder why the swelling has not gone down.Three joints - the DIP (distant interphalangeal is nearest the fingernail), PIP (proximal interphalangeal is in the middle), and MCP (metacarpal phalangeal is nearest to the hand) make up the finger. The DIP and PIP joints both have a ligament on either side of the joint. One of these, the radial collateral ligament (on the side that the arm's radius bone is located), is the most commonly sprained or torn finger ligament.
Feel the sides of the PIP and DIP joints for tenderness. Pain is located directly over the side of the joints rather than below the joint. Have the victim grasp the end of the injured finger and stress the joint by moving it sideways to see if there is excess movement. This test reveals pain or weakness in the ligaments that is not noticeable with normal extension or flexing.
If the joint moves from side to side, splint the finger in a flexed position (as though holding a baseball) until the pain stops. The victim can still use the hand, but the finger should be protected by "buddy taping" it to an adjacent finger. In the case of an unstable finger, seek medical attention.
Frequent sprains may cause permanent enlargement of the knuckles. Finger sprains need prompt and proper care. It takes weeks to heal a ligament, and if the injury is not protected, the problem will remain for life.
Initially after the injury, use the I-C-E treatment:
I
ice or cold applications for 10-15 minutes, three to four times daily. Put ice chips or cubes in a plastic bag. Wrap the bag in a moist towel and place it over the injured area. Do not apply heat until 72 hours after the injury.
C
compress or wrap with elastic bandage or other bandage that will compress the joint.
E
elevate the part above the heart's level.
Jammed fingers should be left alone - do not pull or bend them. Later, rehabilitate with contrast baths and anti-inflammatories. Use the finger muscles themselves to exercise the joint, not the other hand pulling and bending it.
Seek medical attention if:
- Pain and swelling last longer than two weeks.
- If there's numbness or coldness in the finger or the fingernail turns blue or gray.
If the finger has never been injured before, and if it gets proper care and sufficient healing time, it shouldn't be permanently disabled. Ligaments have a poor blood supply, and torn ligaments require as much healing time as fractures. Average healing times are:
- Mild sprains - two to six weeks.
- Moderate sprains - six to eight weeks.
- Severe sprains - eight to 10 weeks.
Alton Thygerson is a professor of health sciences at Brigham Young University.