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Broken Pinky Finger - Post Surgery Stiffness

imq
I had surgery done on my broken pinky finger on January 1, 2008, which I broke while playing football, and I was in the cast for 6 weeks after that. After the cast came out, the doctor told me to go to therapy for 6 weeks/ 2 times a week to get rid of the stiffness in the finger. Now it is May 5th, 2008 and I have 2 more weeks of therapy left but still the finger is a little stiff. I can bend it but not fully and in terms of going back up it doesn't move at all.

The therapist has told me that doctor's could do another surgery to loosen up the tendons but I will wait to ask a doctor until my therapy is done.

The questions that I had is:

1) What are the chances that I can still gain full momentum in my pinky finger?
2) If I am not able to get the stiffness out, can anyone tell about the surgery the therapist was talking about?

Greatly appreciate your help.

Thanks
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Avatar universal
DO NOT GIVE UP :-).  I fell and had a complete break of my pinkie right through the knuckle (right dominant hand) on 6/20 with a lot of soft tissue injury to the rest of that hand and wrist but no other fractures. Because of the severe swelling, I did not have surgery until 8 days later (only a temporary splint). Then I had one K-wire from the back of the hand, through the broken knuckle, and all the way through the finger to past the next joint to stabilize a badly rotated middle third of the finger, with a huge splint thingee all the way up to the elbow. Then a smaller splint to the wrist. All this time the entire little and ring fingers were totally immobilized until the pin was removed 7/20. I had to keep the whole arm up on pillows, above my heart, all that time and for several more weeks because of the severe swelling. So now there was absolutely no movement in the pinkie or ring finger, and because of the way they were immobiIized and the injuries to the rest of the hand, I had to do therapy on all 5 fingers. Oh my goodness, what pain and terrible swelling that got worse after each therapy session. I had not been told to keep any of the fingers moving when I removed the splint once a day for hygiene. Thank God I found the posts on here. I switched to a CHT at the hospital, instead of the ones who work with the surgeon, and after almost three months (THREE MONTHS!!) of grueling twice-a-week sessions with her and many sessions daily on my own, today I walked into my surgeon's office and said, "Look at this, I can make a fist and my pinkie is touching my palm." His eyes bugged out because he was insisting for two months now that I would need another surgery to release the stuck tendon. What I did: I visualized every AM and PM my finger touching my palm and showing and telling the surgery exactly what I did today ... I faithfully did as much therapy as I could possibly stand (in spite of feeling like giving up 3 times because of pain and lack of much progress) ... and third, I was determined to not have any more surgery. Up to 50% have either no result or a poor result, and I was not having any of it. Period. I did not give up and pushed through all pain and forced myself to do the therapy as much as I could stand, and last week I heard a big POP and a CRACK while I was getting dressed and had severe pain in my palm & pinkie and ring fingers, with much more swelling and pain for several days. But I kept doing my therapy as much as I could and was amazed at the massive improvement. The suggested splitting open of the entire finger on the top of my hand to release the tendon would not have worked because the pop and crack happened in the palm of my hand and underneath the ring and little fingers. Today I had gained 40 degrees and 50 degrees more motion in the two distal joints when my therapist did measurements. After only a week and after months of very little progress. She said it is a miracle! So DO __NOT __GIVE __UP :-). If I could do it, you can do it. Just make sure you have a therapist who is positive.
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Avatar universal
Hi everyone, I got so much out of this thread and I wanted to share my story with you. I had unstable breaks of both Pinky and Ring fingers. Both were Proximal Phalanx near the MCP joint, similar to Colnago_Rider. 2 days after the accident I had K-wires inserted in both fingers, the surgeon used a real-time xray to get the K-wire and bone alignments where he wanted them to be. I had a cast on for a week, then a plastic splint for another 4 weeks. Physio started after week 1, but it was difficult to do much because of the pain.

The K-wires were removed after 5 weeks and like so many others I had 2 "concrete" fingers that would not move. Reading about others in a similar situation was incredibly helpful, I gained knowledge that was not forthcoming from the doctors and it inspired me to persist and go hard with the physio.
7 weeks from the accident without much change, I was doing blocking exercises and I felt a ripping sensation in the ring finger and it started moving a few degrees! The movement for a few days was accompanied by wierd vibrations, this went away and the range of motion steadily increased.
9 weeks from the accident, the pinky started to ever so slightly move and over the last few weeks I am getting on average an extra degree or 2 each day. It has not hit 90 degrees yet but I think there is light at the end of the tunnel. It is not behaving at all like the sudden increase I got from the Ring finger.

I think that the things that really helped me; a surgeon that wanted to use K-wires, getting the wires within 2 days of the accident, having a hand specialist that wanted me to do such a high intensity of exercises that I was permanently in pain with extra swelling.

I have been so encouraged by Walker15, Colnago_Rider and yeswecan537. I think yeswecan537 might be onto something with his "failure bias" theory, so I'm so glad I can share an outcome that is looking increasingly positive.

Don't give up! Go hard and long on the exercises...
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Avatar universal
Hi everyone.. My previous post  was some 3month back when I had done 1 month  of  physiotherapy.. Now it has been 5months.of almost daily physiotherapy. I want to share it with all suffering  from  post fracture  finger  stiffness..the key to get ur finger normal or at least nearnorml  is that u just don't  give up physiotherapy..it really takes time and patience before u see some improvements..everyday I had to go through a lot of pain to bend to stiff finger and in 5 minutes of rest it again  gets stiff for 3months  there was like minimal improvement. Many times I felt  like stopping  physiotherapy but I knew it wont help me. So I decided  not  to  think  about  results  and  outcomes  and just focused  on my daily  physiotherapy  and range of motion. Everyday  I had to  go  through  hell  lot of pain to touch my finger  to palm..and  after  5 MOnth I felt the improvement.. Swelling  is decreased now..its easy now to bend the finger  passively.. Finger feels  like normal although  its still  a long way  to go..but I am hopeful now.. So just keep maintained  your range of motion . don't give  up physiotherapy and do exercises by yourself  also.. Don't loose hope.. No pain no gain.. Remember your pain will not last forever but what you will after some time  will give you happiness
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Avatar universal
Bless you al guys for this posts!! I dislocated my pinky finger and had some ligaments broken because of this. The doctor put a splint on my pinky finger and the ring finger ( the dominant right hand..). After 3 weeks, I had a shock. My pinky was stiff as a rock and my ring finger which was perfectly fine is bearly moving now. I cried every day after I removed my split thinking I'm only 31, my life is done and so on. Of course I'm exaggerating but I'm having a breakdown. Thanks to yours posts, I'm getting hope again. My hand therapist is encouraging me.. But I have zero faith. I didn't think that a pi my dislocated finger would make my life so miserable. I'm off the splint for 5 days and I see zero improvements... I hope that I will be heathy again, the way I was, and all of you having the same problem. Be strong, and again thank you for the advices and posts, because you are giving faith to all of us
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1 Comments
I suffered an open shaft fracture, left pinky (non-dominant hand), proximal phalanx at the beginning of July.

Slipped off the edge of a porch on holiday in Germany after evening rainfall and fell several feet landing on a building gravel. Hand wasn't a pretty sight (soft tissue damage) requiring immediate visit to A&E.

An orthopaedic doctor reset the dislocation (along with x-ray, wound debridement etc) and the fracture was fixed w/ 2 crossed K-wires under local anaesthesia by a hand specialist the following day. I was very lucky in this regard.

I was discharged and sent back to UK with no splint but instructed to keep flexing/extending the fingers. I had reasonable mobility but felt as though the wires were inhibiting me worried they might break so I didn't push too hard. I could make perhaps half a fist but straightening was almost impossible.

After a lot of running around and uncertainly on my part, the NHS fixed me up with a splint (protected mobility) at week 2 and removed K-wires at week 3 and prescribed weekly visits to a hand therapist.

In addition to surgical incisions, the original exit wound (base finger & palm) took almost 4-5 weeks to heal sufficiently where I felt confident enough to push harder with exercises without re-opening the wound. This also allowed me to massage the scar tissue which seemed to loosen up the tendons.

It's now week 6 and mobility has been returning gradually and currently just under 90 degrees at PIP and 70 at DIP (I think) unaided. . Still some numbness at fingertip and along the outside edge of the finger and there's a slight bump on the DIP joint. Hand therapist says this is common with this type of fracture and given me additional straightening and massage exercises and splinting at night. I'm incentivised by visualising playing the guitar again one day and will stick with the program.

I've had to be pro-active and devote all of my time to try to ensure I saw the right medical people and in a timely manner. I sought lots of opinions from the nurses dressing my wounds, to my GP signing me off work, to getting a second opinion, as well as reading up online.  As many have pointed out on this forum, sitting back and waiting isn't an option. I shall endeavour to update again.



Avatar universal
Hi all..i suffered this left hand pinky fracture at proximal phalanges..it was transverse and my whole finger was twisted inside..looked very scary..very next day i got k wire fixation..and after about 3.5 weeks of immobilization they were removed.finger was stiff ,PIP  was swollen n so painful.very next day i started on PT almost everyday..now it has been about 1 month of daily PT.my passive range of motion is completely back and it comes within 5 minutes after starting PT but active ROM is still lackiñg.i cant make a fist still on my own..PIp joint is still swollen pretty much..finger is stiff..and morning stiffness is a problem..my PT says that because i have gained full passive ROM so active ROM wil definately come..is it so?? Can anybody give some advice on my situation..
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Avatar universal
My injury sounds identical to yours. I had the wires removed about a month ago. I can make a fist and open hand but I assume the finger will always be crooked. It is still painful though. I'm just wondering when the pain will go away when I make a fist.  Doc told me to massage the pinky finger to get the swelling liquids to disipate. I have this rubbery gauze that wraps around the finger. That helps.  When I unravel it at the end of the day The swelling is down.  Just hoping that someday I dont feel any pain when using my hand.
Ughhh.  Needless to say I quit playing DODGEBALL.
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Avatar universal
Hi
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Avatar universal
To straighten the finger again is difficult, the extensor tendon does not have much power and cannot glide if there is much scar tissue. You should ask a hand therapist for exercise, basically you should keep trying to straighten the finger, and also to straighten it and then try to hold it in place (to try to get the tendon to move through the scar tissue to hold the finger without the added work of actually moving the finger). Also make sure you can passively still straighten the finger so the joint itself is not resisting.
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Avatar universal
Hi harry,

Don't give up.  I started playing guitar back in 2008.  However, in 2002 I broke my left ring finger playing football.  It was a bad break at the DIP joint, through the joint causing angulation and malrotation.  Well, I went tot he doc and they splinted it to avoid surgery.  I didn't know anything at the time.  it healed, but it healed crooked.  My ring finger bent OUT towards the pinky about 20 degrees.  I learned to live with it, and I even learned how to play guitar with it.  In 2013 I had an osteotomy done where the surgeon actually took a wedge out of the tip of my ring finger, derotated it and bent it further back towards my middle finger.  This corrected the angulation about 15 degrees.  What an improvement.  Is it perfect?  Absolutely not.  I have minor arthritis there, some annoying pain at times, and it still is off by a few degrees.  However, I regained all of my ROM back.  Despite destroying that joint, I can bend my ring finger almost a full 90 degrees at the DIP joint.  This was after having a pin in my finger for 5 weeks.  Your hands adapt very well.  Even if your finger next becomes "normal", you can still be a proficient player.  I play in a band every week and I play guitar every day.  Sometimes I get annoyed with it, but only because of how it looks. :-)  In reality, it doesn't affect my playing.  I can do lots of fast lead runs and can form pretty much any chord without issue.  If I can do it, you can too.
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Avatar universal
A dog leash broke the middle bone of my little finger on my right hand. I needed surgery as the finger would have healed malformed. My surgeon used a screw to secure and keep the bones in place.  

After surgery I wore a dressing for five days and had to avoid using the finger.Once the dressing was removed I had to keep moving the finger but no gripping or weight bearing for three weeks, then I could start gripping but limit myself by how painful the action was.

The finger was never splinted and at 8 weeks post surgery, my finger has full movement. I am still advised not to do any heavy work, until the finger is completely healed.  I am going to ask to have the screw removed as its head is by a joint and is painful were it sticks out covered by skin.i have another appointment in June to discuss this.

The most annoying issues with this healing process are not being able to drive due to gripping the steering wheel, being guided by pain, knocking the finger amazing how many times I did this, people not realising as there was no splint, the finger just looked swollen and bruised. But  I have full movement in the finger and IMHO a little time of frustration is good trade.

This was all done on the NHS by a specialist hand surgeon who knew what he was doing. I am very grateful
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Avatar universal
I broke my pinky on my left hand. I went to my GP and he told me to tape it to the other finger and come see him in a month. I never should have done that the bone kept hitting the other bone and splintered. Make a long story short a had multiple surgeries with an implant being put in. I tried to get my range of motion back with tons of physio but it did not work the implant would squeak and not bend. Amputation was suggested. I said I would think about it.
Well, it is 3 years later and the reason I am writing this is I slipped and stuck my hand out and injured it again. Amputation has been suggested again and I am actually thinking about it as this has become quite painful. I was given 3 options for amputation right at the second joint  where the implant is leaving a stub,right at the base of the finger or complete removal grafting the side with an angle cut so it kinda flows into the ring finger. Don't know what to do just was wondering what everyone thinks.
Really struggling with this.
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Avatar universal
I injured my right middle finger while playing basketball. The finger droops badly. I went for the operation 1 week after the accident to have 2 K wires inserted into my finger.
The K wires remained in the finger for 5 weeks and I was advised to wear my splint for the next 2 weeks.

After 2 weeks of splinting (after K wires removed), my finger still droops  a little (around 20 deg). I could't bend my injured finger too. When I close my hand in a grip position, all fingers were are able to bent except the injured finger.

Question 1: Is it normal to have my finger droops after K wires operation for mallet finger?

Question 2: What are the exercises to regain my range of motion.

Question 3: Now my finger still droops after the operation, what are the things I can do so that my finger can be straighten without the droop?
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Avatar universal
I had a displaced fracture on my right pinky on Sept 30, had surgery on Oct 3 with 2 k wires inserted and was immobilized in a cast for 4 weeks afterwards.  I had my cast and pins taken off on Oct 31 and as expected I was very stiff and the finger was swollen.  I came across this site and was very scared.  The next 4 weeks I went to hand therapy 2x a week and did the excercises as much as I could at home everyday.  I was told in the beginning that my finger is on the stiffer side of things and that I may need tenolysis.  All my rehab and hard works has paid off, currently 4 weeks post pin/cast removal I have 75 degree movement on my pip and 70 on my dip, MCP is as good as new.  I still have a bit of work to do to make a full fist but I think I can get there in the next month.  So to everyone with a stiff finger, just work hard and stay positive and you will get there.  My progress on my pip is as follows: week 1 -20 degrees, week 2 - 45 degrees, week 3 - 65 degrees and week 4 - 75 degrees.  I resumed weight lifting (machines) on my injured hand starting in week 2.  Stay positive everyone and good luck!  Oh and I never had any weird adhesion breaking sensations, all my progress came on gradually I never had an incident where I felt a pop and suddenly gained a bunch of ROM.
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Avatar universal
Hi Knightraino6 did you ever get back the full use of your pinkey finger after the break.  I am going thur the same thing right now & it has been almost 5 weeks & I still cannot bend my finger very much.  thanks
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Avatar universal
Hi Knightraino6 did you ever get back the full use of your pinkey finger after the break.  I am going thur the same thing right now & it has been almost 5 weeks & I still cannot bend my finger very much.  thanks
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10565177 tn?1414082048
Has anyone had any luck with breaking up their scarred tendon tissue from bone?
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10565177 tn?1414082048
Hi
I hope you're still getting notifications if someone responds to you. I would like to know exactly what moves/exercises you did, to break up your pinky scar tissue back in 2009. I have the same issue. My DIP is tipped down at about 25 degrees-in other words I cannot lift it up to straighten it more than that degree. So, it's never completely straight. It's almost certain due to the tendon being stuck down from my March dislocation, of which I did not realize was occurring until 7wks later. =O This is driving me crazy, not being able to 'lift up' the tip. Please respond with what maneuvers you did to break scarring! Thanks!
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Avatar universal
Hi, Welcome to MedHelp. I am the Orthopedic Community Leader. I am also a Orthopedic Surgical First Assistant. The website you are looking for is below:

http://en,wikipedia.org/wiki/pseudoscience

Thanks  JD1963
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Avatar universal
Dog leash broke pinky about 2 years ago.

Used duct tape and pencils to make a cast using the the ring finger as a support. The cast was removable and covered palm and knuckles. Left it on for 6 weeks.

Forgot about movement exercises and it got stiff but could still play guitar with it kinda.

The reason really for this posting is because of the meridian points connected to the pinky. If you Google "wingmakers" and "fire meridian pinky" you will find the importance of your pinky and its movement.

In short the small intestines lock up and cause much discomfort which the body experienced many effects on sugars prior to the massaging of the pinky such as, a fire in the chest that kinda reminds of claustrophobia or something similar. I find it pertinent that this information is available because of the issues the body went through due to the pinky being stiff which caused much discomfort in the body all over, it was confusing. When the information became clear then so did the issues in the body that was leading to much annoyances and intolerance to many situations with social interaction/food/sleep.

A technique that was used was taking duct tape and wrapping it around the pinky when the threshold bending was reached and leaving it on for about 6 hours and massaging the pinky in that position all over. During this process the organs unlock and much discomfort is evaded. Remember its the body, not you.
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Avatar universal
Hi there, I cut myself chopping food with a brand new knife, 95% laceration on left hand index finger, extensor DIP. Surgery after 10 days, including spending 3 days mulling it over - they told me if I've cut it pretty bad, then it won't heal on it's own and it looked 75% cut from lack of bend.
Went for the surgery, had under LA, no complications, all went well. Told me it was 95% laceration. Well done me :-/
Splint and bandage for 5 days, agonising pain, then dressig removed, and fitted with a custom made (thermo-plastic) splint - after the 5 days.
Then 5 days later, (day 10) - went to have stitches removed.New splint fitted as swelling had gone down. Told to stay in splint and not to bend under any circumstances for 3 weeks.
Had 3 week check-up, told everything OK, then 3 more weeks.
At 6 weeks, told to move/try to bend it. Sent to certified Hand Therapist after this appointment (as my hospital is not local).

CHT said OK, now it's been 6 weeks, we can start therapy, got me to do loose fist & lift and hold. No movement from DIP doing loose fist but could just about do lift and hold.
She said for 1 week, remove splint only for therapy - 3X a day every day, loose fist x 10 reps and lift and hold x 10 reps.
That was week 1.

Week 2, she said same exercises 3X a day but remove splint for 1 hour a day, 3X a day and do light activities and a 3rd exercise - actually bending the tip over the edge of a flat surface (whilst holding down the PIP joint).

Week 3, I went and showed her my progress, she said she was not happy with the bending exercise, it was not progressing fast enough, she said I need to start using it more, getting it in warm water, fiddling with things, anything to encourage movement.
So here I am nearly at the end of Week 3 and due for my next CHT appt in 2 days and the bending exercise still doesn't seem like it's progressed. I don't have anything to take measurements with but I'm guessing it's only 10%.
PIP seems OK, it is stiff from the splinting (it had restricted movement as the splint was taped up and the tape extended to cover my PIP joint and I didn't question it).
I have over 90% bend in the PIP after a few wiggles to warm up.
I can make a fist but DIP does not bend and sticks out a little.
Still have a little swelling and numbness.
Lack of movement is making me very frustrated and upset and I end up crying everytime I read something negative. I was advised this was the best course of action for me as it was a clean cut, no crushing or knocking, no boney fracture.
I'm 31, from the UK but living in NZ for 2 years on a working holiday visa.
Would appreciate yours and anyone else opinion.
I feel like I need support from people who have been through this.
Thanks :)
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Avatar universal
Hi, does anyone know where I can find the finger exercises to see if I can get my finger to bend again? I can't seem to find them anywhere.
Thanks!
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Avatar universal
Your comments inspire me. I fell hiking in Adirondacks in October and got a bony mallet injury on left pinky. I did nothing for 5 days then splinted it on my own with popsicle stick on whole finger then on top of of the joint. Finally went to see someone at 3 weeks post injury. That's how I found out it was a mallet injury. They made a splint which I wore for 8 weeks then x ray showed no improvement and now I wear the splint at night. The bugger of all this is that I play guitar and had to relearn the entire Nutcracker suite to perform in December without my pinky. Now I am using it to play but of course it hurts & my nail is buckling upwards. See the doc next week, I may not do surgery after reading everyone's comments.Although it hurts, I have 90% mobility.Thank you for your comments.
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Avatar universal
Hello all,

Firstly, thanks to everyone who has posted on this thread.  I have just read it from beginning to end and am a lot wiser than when I started reading!

My position is similar to many here:
19 October 2013 - Broke pinky finger playing rugby. Boned sheared across the proximal phalanx. I initially thought it was not broken and waited 12 days before getting an x-ray.  The following day an orthopaedic doctor recommended surgery to reset the bone.  The surgery took place on 12 November.  I was told to remove the bandage after 2 days and try to move the finger joints as much as possible.  On 19 November I had my first appointment with the physio to start the rehab. Despite the swelling and pain I thought I was making pretty good progress with the rehab. I was very good at working on my flexion however I did not realise the potential for extensor lag. The physio recommended the usual stretching exercises and I have been quite diligent in carrying this out. 4-5 weeks post-op I found my range of extension starting to reduce slightly from about 40-45 degrees from straight to 50-55 degrees.  

On 24 December I saw the orthopaedic doctor for a follow up.  Unfortunately it was not my original surgeon but she was a hand specialist so I accepted this.  My new x-ray showed that the bone had healed pretty well and straight.  However, she was concerned about the tendon lag and recommended a new surgery to address this. I told her I would think about it. I decided to continue work with my physio and leave the surgical option open for a later date. Since then I have been working flat out to improve the lag.  I have used a capener (sprung) splint to keep my finger extended during the day and a fixed splint to keep it extended overnight. I am doing a range of passive and active stretching and strengthening exercises.  I have also got a box splint which enables me to keep the finger in maximum flexion.  The finger is still very very stiff in the mornings and stiffens very quickly when I am not using it.

Having read the previous posts I am convinced that the non-surgical route is worth persevering with. In particular I am interested in the people who say that the blocking exercises have helped to free the stuck tendon.  I am working much harder on this and will report back on my progress.  
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Avatar universal
3 and 1/2 weeks out from tendon surgery and my pinkey finger cannot extend much at all. Very pissed because doc never warned me that this could happen. It's bent over about at 80 degrees from the PIP. I can passively retract it down but actively I have very little movement. Passively I cannot extend the finger passed 80 degrees, feels totally stuck. Anyone know if PT can do anything for this level of "stuck," or am I destined for tenolysis?
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