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Broken Pinky Finger - Post Surgery Stiffness
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Avatar_m_tn
Broke my pinky on Oct 8th, 2011 but didn't know it and had surgery two weeks later. They put 4 pins in. Never was in a cast just a splint and my doctor warned me about losing my range of motion if I didn't really work hard at it in therapy. It's been 6 weeks since surgery and I'm doing the therapy thing and I had about 80% of my motion back when my therapist decided to measure my grip strength the week before last. When I did it with my hand that has the broken finger she was suprised how strong it was. Well the next week I go back to therapy and I was going to see the doctor right after but for some reason she wanted to measure my grip strength again. So she tells me to pull as hard as I can which I do but feel something. I go see the doctore maybe 10 mins later and now one of the screws has come loose and it looks like the whole break is open again.
I'm seriously pissed right now. The doctor is trying to make me believe it couldn't have been that but I am 100 % sure it was...now what another surgery to lose more motion and have to pay for that and another round of therapy.
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Avatar_m_tn
well it's been about 3 months of OT  (2x a week) and just had consult today w/ surgeon for tendon release surgery. unfortunately I got shot down by the doc. he want 6 more weeks of progress on passive range of motion b4 he'll  give the green light. I got passive range back to about 70%. I can wrap my hand around a pair of handle bars again well enough to ride almost as aggressively as I did b4 the injury. I'm told that recovery time from the tendon release surgery should only be about 2 weeks because it's just tissue trauma, no bone healing required. I'm pretty psyched about it. hopefully this will all be behind me and I'll be good to go by next season. if one thing I've learned from this it's if your 're gonna crash… don't land on your hand.
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Avatar_f_tn
Last Friday, I fractured my right pinky finger during a basetball game. I went to my regular doctor to get x-rays. x-rays confirmed I have a displaced fracture to my middle phalanax in my pinky along with torn ligaments and a bone fragment that chipped off of my pinky joint. I was sent to an orthopedic surgeon who put me in a cast for 2 weeks. my pinky and ring finfer are in the cast along with the rest of my hand about half way up my arm. my middle, index, and thumb are free from the cast. The position my last 2 fingers are in are bent in the cast. He put me straight into  this cast. No surgery or anything before the cast was put on. He believes the bending of the fingers in the cast will allow the ligaments to pull the bone fragment back where it is supposed to go. Does this seem possible? Does anyone think I will need surgery? Will the cast make my pinky too stiff that I will need surgery?
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992527_tn?1299208415
Be careful about physio after tendon release surgery. Read my earlier posts. My tendon ruptured after mine (well, actually my second tenolysis) - so don't push too hard. If your tendon ruptures, you're really screwed, as I was - you then need two more suregeries to try and fix, which I never did. Therefore I have lost full movement of my pinky at dip and pip.
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992527_tn?1299208415
please read up as my experience with being splinted with pinky in a bent position. Two weeks splinted may be OK but try to move dip as much as possible while casted. Do not stay casted more than two weeks.
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Avatar_m_tn
I like some others wish I found this board sooner!  I fractured my right pinky, ring, and middle fingers on 11/19.  Visited with the Hand surgeon on 11/21 and had surgery on 11/25 then visited with OT/CHT on 12/6 for first time and got a new splint.

Fractures were the following:
Middle - directly above MIP (two pins inserted to stabilize break)
Ring - between PIP and MIP (plate inserted to stabilize bone & two removable pins)
Pinky - between PIP and MIP several small breaks (two pins inserted)

On 12/21 I had the pins removed and then couldn't schedule a OT appt until 1/5. I wish I hadn't waited and I wish I would have insisted on going sooner.  My OT even said she submitted a therapy request to the doc with a plan for me but he turned her down because the breaks weren't fully healed.

Now I've been to two OT appts with the third today.  I will try to remain positive but right now,  7 weeks out, I have no movement in the PIP/DIP joints unassisted and some movement assisted. They are extremely stiff although we've heard some popping and tearing of the adhesions - she's gotten very excited when she's heard that.

My question is what can I do at home to help try and release the adhesions as much as possible?  It's my dominant hand that I've injured so some of what she does with both hands is very difficult with my weaker hand...
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992527_tn?1299208415
Just make sure you are doing the prescribed therapy. You are 7 weeks post surgery and in a very tenuous position right now because your surgeon delayed your OT. I wish these morons would better understand that a well healed bone with no movement and tendon scarring is worthless without a good chance of regaining ROM. You didnt say how you were bandaged - or worse - casted during the post surgery. Were you DIP exposed? Could you bend those joints (and its MCP, not MIP joint)

My best advice - take codeine before your OT visit, and work the fingers until you are ready to black out. If you're not crying, you're not working it enough. You're window of having any chance to break your adhesions is closing, if it hasn't closed already. Having all those fingers broken is rough. One is bad enough. Constant movement on your joints is needed, passively and proactively. Soak in hot water at home and do it as much as possible. Your OT should give you a list of exercises, tendon glides, etc.

Time is of essence. I can't believe they delayed you as long as they did to get you OT.  I swear, just once I want to hear of a hand surgeon who truly understands what they are doing....

Two years later, and I'm still carrying a grudge - sorry. When you lose your finger due to an incompetent doctor, its a hard pill to swallow.

Do not lose hope though. Read through this post - theres a few that things worked out OK for.

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Avatar_m_tn
I broke my metatarsal below my pinky and there was apparently a second, unremarkable fracture. On 12/16 i had four pins placed and was put in a hard cast for three weeks and then put into  removable splint.  It has been three weeks since the pins have come out. I have been in PT three days a week beginning a week prior to pin removal but really saw little progress till pins came out. My pinky was stiff as a carrot and ring finger was pretty stiff as well and I had a good deal of swelling. Last week my doctor gave ok tht fracture was sufficiently healed for PT to really get aggressive. I had no idea of what aggressive felt like... yes, tears of pain.  I have seen some progress but not great - more progress on bending and less so on straightening and strength is nill.  I was given a tension splint to be worn 6 times a day -- talk about pain. I am pushing as hard as I can but I am still not at a point where i can grip a steering wheel and safely drive.  I see the doctor on 2/16 for a re-evaluation and he mentioned a second surgery... which i really do not want to have.  It is a long and painful road - I too broke an ankle and wrist - but breaking this pinky is far worse.  How do I know if I am doing enough .. I want to give this my all because surgery appears to only create more problems. And yes, no one can imagine how painful post surgery is on a hand.... it is weeks later and I still have shooting pains during the nite presumbly from muscle and tendon tightness nd swelling is still there. Any advice you can offer would be appreciated. Thnk you.
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992527_tn?1299208415
Wish I had good news for you Elmo. I doubt the tension splint will do much. Take codeine before your OT visits - and hopefully you are going to certified hand therapist not a physical therapist. Theres a big difference.

You'll likely need joint contracture surgery coupled with tenolysis for your flexor tendons, and extensors. Your ring finger is also injured due to the splinting. Was your finger splinted at an angle?

Right now you are 6-7 weeks post surgery. Finger's been immobilized for that time which just compounds the problem. Presumably your PIP was also immobilized.

You're up against the clock, or past it. Do as much passive(assisted) ROM as your can. Read every word of advice here on the this thread. Dozens in same position as you. Bend the fingers with your therapist until you pass out. Only chance to break the scarring on the tendons. But even that, very few people free their tendons on their own. I think in this whole thread there's only one.

You can't do surgery for another 3-4 months until all the swelling goes down. Until then they'll have you get as much assisted ROM as possible. Be careful after the surgery that your don't rupture the flexor tendon (like I did).  I'll spend the rest of my life without a pinky that bends and sticks straight out when I grip something. Were it my dominant hand I would really be screwed.

Judging by the amount of doctors who seem to not know how to deal with a pinky fracture, you're clearly not alone. I spoke to one of the most prominent hand surgeons (after my finger was ruined) on the east coast who told me he would have done surgery, used kwire and had me bending the finger within three days of surgery. For me, my idiot doctor splinted for over 6 weeks. Its too late by then.

Sorry pal, wish I had better news. Do the best you can but be educated about what you are up against. Make sure you're surgeon knows what he's doing. Judging so far, I'd say maybe he's not so up to speed.... I dunno.

Obviously I'm no doctor, but in preparation for my lawsuit, I researched the hell out of the topic. And I lived it. Take it for what it's worth.
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Avatar_m_tn
YAHOO!! approved for tenolysis surgery on 2/13. can't wait! 2-3 weeks of aggressive everyday therapy afterward and I'll have this in my rear view mirror finally. timeline so far broke down like this: accident last week in July, 1st surgery -  august 16th. all pins and fixator removed 8 weeks later. Went to physical therapy FOREVER.  approved for 2nd surgery yesterday. almost finally over!

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992527_tn?1299208415
Good positive thinking. I hope your tenolysis surgery goes well. Just be very careful post surgery; my flexor tendon ruptured 6 hours after my surgery. Doc told me to bend it, and I did, and popped it.

Ask about the extent of the damage to the flexor tendon, and how strong he thinks it is before you go very agressive on the OT after.

If the Flexor tendon ruptures,  its pretty much game over unless you go through another two surgeries, which I did not do.

Good luck and please post back after....
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Avatar_m_tn
Broke my left ring finger skiing on 1/6.  ER told me it was a severe fracture of the joint (PIP), and I needed surgery.  Saw the hand surgeon on 1/11. Told it was an extremely rare and serious injury, with a 20% chance it would be stuck at 90 degrees and another 10% chance it would be stuck at full extension.  Had surgery on 1/12.  Got donor bone graft, a pin and K wire. It was a success, and doc said he was able to bend it to 90 degrees in surgery and fully extend it as well.

To my surprise (but apparently not to the surprise of Colango-Rider), my surgeon started me on physical therapy less than 24 hours after surgery.  Today (2/6) I am at passive bending of the pip joint 86 degrees, with full extension.  Can get to 50 degrees with blocking exercises.  Was very worried, because it seems so bad, to not be able to actively bend my finger too much 3.5 weeks after surgery.  But this board certainly has reinforced my opinion that I found an amazing team - great doc, great hand therapists, and, yes, great insurance.  

I'm still worried about the DIP joint - not broken, but hard to bend and will not straighten.  They say taking out the K wire will fix that.  They also said I may need the tendon release surgery, but it is too soon to tell.  

I'm worried I won't get full range of motion (prior to surgery, doc said a good result would be movement between 30-70 degrees. I can already fully actively extend, so better than that, but we'll see on the bending).  Never realized how hard it was to recover from finger breaks!  Good luck to everyone!
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Avatar_m_tn
yeah, I asked him about that happening because of what you had wrote on this board. he said rupture shouldn't be a concern in my case because the tendon had not been "frayed or stressed" in the initial injury or surgery. he said that tendon rupture can become a concern if there was weakening of the tendon previously. I appreciate the info. This board has been helpful. I would not have recognized that as a possible concern if it hadn’t been for your post so I thank you for that. I'll get back w/ the follow up after the two weeks of post OT and let everyone know what the final outcome was with this whole event. I wanted to be able to provide a time line for those beginning or in the middle of a similar situation so they have an idea as to what to expect to go through and how long it all takes from injury to full recovery
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Avatar_m_tn
Hello, I am writing to add my finger injury to the blog.  I am a Police Officer that was injured while struggling with an offender. I went to the ER and they told me that my right hand pinkie was a mallet finger. Then I went to a specialist who put my finger in a splint for 9weeks. Then he did a surgury of pin fixation for 6weeks.  The pins were removed and I went to hand therapy for 5 months.   The finger would still not bend and I could not make a fist.  Because this injury was work related my employer sent me to a second opinion MD who stated that I needed to a tendon fusion surgury done which they would place a pin and a screw in my finger. The screw stays in permanently . I then had 4 months of hand therapy and went back to work light duty.   The MD says I have a Permanent injury  and  limited work restrictions because this is my dominant hand.  The MD is recommend tendon release surgury, but I am not interested in having a third surgury done which may take away further movement from my hand.  I am now in a postiion at work where they came out with new rules for limited duty officers that state you must be able to perform the essential duties of an officer in order to remain  in a limited duty position.  The main ones that effect me are that you must be able to punch and hit a combative resistor.  My MD has already informed me that I have a permanent injury and I am un able to perform those requirements so I will have to apply for disability/pension benefits in the next couple of months.
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992527_tn?1299208415
9 weeks in a splint. Sheesh. If you read up on Jupiter Police (also another guy on the job), he had similar issue. Tendon release could perhaps work, but you have had a lot of trauma on the tendons and I believe might have strong possibility of tendon rupture post surgery (like I had). It would depend more on how much tenolysis was done initially on other two surgeries, but maybe not a lot was done.

I believe Jupiter may have also needed to go OOD, as his surgeries were not able to correct the issue, and his finger was trigger finger.

That really ***** though that your first doctor sounds like mistreated the injury. I was agravated enough to learn how the splinting screwed my finger - and mine was splinted 6 weeks. I can't imagine why yours was splinted for 9 weeks.

That's actually the longest I've ever heard.  Maybe these two knuckleheads are buddies. After you surgery you were again splinted for 6 weeks. So 15 weeks with no movement. No wonder the finger isnt bending. I'd say you have joint contracture issue and extensive scarring on flexor and extensor tendons.

Wish I could be more optimistic for you--

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992527_tn?1299208415
Keep us posted buddy. Yeh, I wish I knew about tendon rupture possibility before my surgery. ONly after it ruptured did moron #2 doctor advise me it was possible. (Um, information that might have been useful before you send me home and tell me to bend the finger as much as possible).
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Avatar_m_tn
so yesterday had the stiches out from my tenolysis surgery. I'm pretty sure I made the right decision to through with it now but thought I had made the wrong choice at first, I'll explain. After the surgery,  I woke up expecting to be able to move my finger the way it had always worked before my injury, not the case. I had no more mobility than I did before I went under the knife. my surgeon then ran by my bed and yelled at me to make sure I bend it as far as it would move, so that's immediately what I started doing. once the anesthesia wore off several hours later, that task became more of a challenge. Opening and closing your hand w/ 35 stiches running from the center of your palm to the tip of your middle finger isn't what I consider "good times". the next day I went in for 1st therapy session fully stitched up. I figured she would start slow since my hand was swollen and very sore from surgery the day before, I was wrong. she proceeded to pop 2 of the stiches open in the 1st session trying to fully extend my hand open. yeah, it was painful and yes, it was gross.  she told me that I had a 2 week window to get the mobility back before it scarred down again or the 2nd surgery would be for nothing. from that point on I decided to pretend my hand was fine and forget about the incision and stiches. I began using my hand as normal w/ the help of a lot of vicodin and went to therapy 5 days a week for two weeks. I went to the gym, rode my bike, did everything I normally do but backed off the intensity slightly. my surgeon told me before the surgery that we could always put in more stiches if needed. I took this to heart.  therapy was a bear, bled a lot and felt as if the incision would split open every time, overall, it was brutal. now it's been two and a half weeks and I have regained most of my original movement from before my injury. there is definitely a lot of stiffness still there in the mornings, and if I work at opening my hand for a while, it will not close well afterwards. I attribute this to tendon stiffness which I'm sure will soften over time. I feel good about having gone through it now that I am seeing progress, but it is not a quick fix. I hope my entries provide a helpful understanding of what may lay down the line as well as hope to some of you. I was told that my fractures were some of the worse they had seen when I came in and now I'm about 90% back to normal. I expect to get back about 95% of my original mobility all said and done. good luck and keep working. you're results all depend on the amount you are willing to do.
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Avatar_m_tn
Get the 3rd surgery (tendon release surgery). Sounds like your only hope. Either that or retire and have a bum finger/hand for the rest of your life. It helped my situation and I had 3 pins in my hand for 6 weeks and an external fixator on for 8 weeks. My whole hand was locked up and w/ the help of the tendon release i got it working again.
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Avatar_n_tn
Thanks to everyone for posting here.  This has been my new "support group."  I fractured my pinky in a cycling accident about a week and a half ago.  Surgery was one week ago today with a plate and 6 screws (hand got caught in the wheel and pinky broke my carbon fiber fork...which demolished my pinky).

The biggest thing I am taking away from this form is to start movement ASAP.  I was in a cast for a few days and now I have a removable splint which I only wear in instances where I feel I might bump my finger. I try to keep it off as much as possible and I am constantly challenging my pinky to move.  It has been one week and I am optimistic I will heal up...maybe not 100% back to normal but my goal is to get very close.  

I am already typing again with no problem which helps since my work is computer related.

I will try to update my progress in hopes of sharing information with others.  At this point I am still gunning for the best and not ruling out the release therapy.

My fracture was on my left proximal (pinky) and it was more of a shatter.  The break was in 5 places and they removed a lot of dead bone during the operation.  PIP flexibility is great right now...the gashes from stitches and the MCP seem like the challenge at this point.

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Avatar_f_tn
Hi, thought I would post an update - timeline to date:

11/09/11 broke my left pinky finger at the proximal phalanges
22/09/11 had my op and 2 k-wires inserted and my arm and hand were then in a cast for 3 weeks
14/10/11 cast and k-wires removed, buddy tapped for another 3 weeks
04/11/11 buddy taping removed and confirmed the break had healed but now because of the build up of scar tissue I need physio to help get back the movement.

I have now has 6 months os OT and have regained 70% passive movement in both PIP and DIP. 25 % active movement in DIP but extremely limited active movement in PIP.

I have seen a hand surgeon who said he thinks the tendons are caught up in scar tissue and i'm going for an ultra-sound scan on 08/05/12 to find out more. I think it is likely they are going to suggest a second surgery to release the tendons.

Has anyone had the second surgery to release tethered tendons, and if so how successful has it been?

Many thanks, Louise
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Avatar_m_tn
I have its was broke pretty bad and I late it heal and its starting to get in the way of me working and doin things so I need to go ahead and get it fixed straight back out its my pinky its its bent also I have no insurance surgery Im tryin to see if there is a hospital in jackson ms or gulfport ms or new orleans
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Avatar_m_tn
I had my FDP tendon on pinky cut, due to a breakdown of communication from the hospital, I did not see a hand therapist till 2 weeks after which done me in terms of scar tissue.

Fast forward 4 months later I had tenolysis. It will be successful, you will get good movement but you may not be fully happy because the surgeon will probably do the minimal as possible to get back movement of the tendon like in my case, but the full movement will not be achieved because of previous scar tissue.

If they took out the scar tissue, and perhaps fixed the tendon, e.g. shave off the knot to make it smooth so it passes through the pullies with ease, it can be much better outcome. I will have to wait for a year and propose my idea to other surgeons to see what they can do.  
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Avatar_m_tn
I highly recommend the tendon release surgery, I was at a stale mate w/ my therapy after 1st surgery. my finger looked like it belonged to one of those weird amazon animals that use their fingers to pull bugs out of holes in tree trunks. Just a weird hook looking appendage I couldn’t do anything with and that was after 4 months of OT. I had tendon release and was back to 90% in a month.  recovery ***** but it's short, only like 2-3 weeks' time to recover and only the 1st week and a half really ***** due to the fresh incisions. once the incisions start to heal the therapy isn’t as bad (see my post from 2/29/2012 for better description of what to expect). my hand is back to functioning now, however it is still stiff in the morning and takes a little while to "warm up", it affects the fingers next to it too (my tendon release was on my middle finger). once things get warmed up, usually by the time I'm out of the shower in the morn I'm good to go. I have gnarly scars on both sides of my hand from palm to fingertip, my finger is crooked, doesn’t open all the way,  but it works well enough to do the things I love. Good luck to all,  your recovery really does depend on how much you put into it, stay positive.  
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Avatar_f_tn
Thanks Brendon, i've booked the second surgery for 12th of July so was good to read about your experience for the 2 weeks afterwards, sounds very painful but worth it. Hope I can be as brave with mine!
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Avatar_f_tn
Broken pinky just below knuckel. Therapy starts in 2 days. Pinky and finger that was casted with it very stiff. Will update
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Avatar_f_tn
Hi guys! I'm so happy I came across this forum. I've read every single post here since the first one. Here's my pinky timeline...

June 28th/12 - Flew over my bicycle's handlebars going downhill. Got admitted to the ER. Received first set of X-Rays. My left 5th proximal phalanx (pinky) was fractured in two places (laterally & 90deg upwards -- basically, a piece of the proximal phalanx was floating).
Under local anaesthetics, the plastics surgeon (hand specialist) did a reduction on my pinky to set it back into place. Took a 2nd set of X-Rays. Docs said they did a good job of reducing it, but surgery was still recommended.
Put a cast around my fingers/hand/forearm (only thumb was freed) and wrapped in bandages.

July 4th/12 - Had my surgery. Hand surgeon drilled two K-wires (oblique & parallel) into my finger.
Formed my hand into a cup-like position and made a cast for the ulnar side of my pinky and palm side of my fingers/hand/forearm. Back of my hand side is exposed (not protected w/ a cast). Middle, ring, pinky fingers, and rest of hand/forearm wrapped with post-op dressings (with enough wiggle room); thumb and index finger freed.

July 5th/12 to present - Been trying to wiggle and bend my middle & ring fingers as much as possible (not injured, but under wraps). Also trying to passively & actively abduct & adduct my pinky against the cast & wrapping, as well as trying to move the DIP. Though not sure I should be doing these movements...?

I will have my post-op follow up with the hand surgeon on July 12th/12 (8 days post-op).
What questions should I be asking the doc? I really want to start rehab asap and get back into sports (volleyball, basketball, swimming, kayaking) again sooner than later.

Were the docs doing the right thing so far?
Have I been doing the right thing by trying to move my pinky in its cast or am I just aggravating my injury and prolonging recovery?
Is there anything else I can do in the meantime before my follow up appointment?

I'm an optimistic person and a fighter. So I believe I can recover quickly... It just ***** not being able to play the sports you love... especially in the summer! :(

I'll update you guys with my progress and I look forward to all your responses. Y'all rock :)
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992527_tn?1299208415
You need to ask how long you have to be casted. I wish you DIP was exposed so you could flex the pinky there. I was splinted for 6 weeks and it ruined my pinky as the tendons all scarred down. 2 surgeries later and had tendon rupture.

I'm surprised you got casted with Kwire- normally k-wire allows for quick retrun to some passive ROM. A well known surgeon had told me after my troubles that he would have used K wire and had me moving the pinky withing a day or two.

Be very careful with extended casting. If you've read anything here, you know what to look out for.
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Avatar_f_tn
Bad news you guys...

I just got home from my post-op follow up (2 K-wire surgery was on July 4th -- see above post), and the doc wasn't happy with the surgery. The K-wires didn't set the bones in the right place. He said that I will be stiff forever especially since my injury was so near the PIP joint if I don't get the second surgery done.
So I will be having a second operation one to two weeks from now. This time they'll be slicing me open and putting metal plates in.
This blows :(

Thoughts?
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Avatar_f_tn
Quick update on my previous posts - I had my second surgery yesterday (12/7) to resease the tendons. My hand surgeon said it went well, I'm bandaged up just now (size of a boxing glove) but can slightly wiggle my fingers. I have the dressing reduced in size on Monday morning (16/7) and then straight to physio. I'll keep you updated on my progress, really hoping I'll be able to get increased movement back over the next week.
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992527_tn?1299208415
Yeh, I dunno pal. I was optimistic cause you had kwire, but doenst sound like it was set properly. Did they xray your finger after setting the k wire?

will you be casted again? how long? can you have your dip exposed so you can have some tendon glide at least while PIP is immobilized?

You're in very dangerous territory right now. I'd ask the odds of regaining full ROM on the pinky. My bet would be you have this surgery, they immobilize you, then in 4 weeks or so, when you get it taken off, you're stiff as a board. Unless this plate is going to allow for immediate ROM. If thats the case, then thats good. If its not, well, read above and draw your own possible conclusion. My gut says you'll need a third tenolysis surgery about 3 months after your next surgery if you can't get ROM immediately after this. IF you can - it will be really painful cause you'll have incisions.
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Avatar_m_tn
I had a crush injury under a roller on my right hand in which my ring and little finger were fractured and the palm of my hand was wounded and got torn from one side near the thumb as it was compressed and the red flesh came out of the wound. Both the fingers were fractured at the middle phalanx. While the ring finger was fractured at two points, the other one just below pip.
Within 24 hrs I was operated and splinted. Due to the depth of the wound they first focussed on it and let the fingers as it were.
4 weeks after the injury when the wound healed a little, they removed the splint and put cast on my fingers. Regular physiotherapy was carried out for 6 weeks. After a few weeks xray showed that the ring finger was not aligned straight at the fracture just below PIP. The upper part was just a little elevated there and it got fixed there as it was healed. Moreover the ring finger cant bend at PIP and almost no active moment there, however passive range of motion is full making finger fully bent at that joint.
Now it is been 8 months to the injury the condition is same.
Any advice?
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992527_tn?1299208415
You will need tenolysis surgery to free the tendons so you can actively bend PIP.
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Avatar_m_tn
I had surgery 5 weeks ago on my middle finger. When taking off the splint my finger wouldn't move at all. My PT told me that I had tendon adhesion and that it will likely require another surgery to release the tendon.

I've been really depressed but the story of Walker15 in this thread inspired me to stick with the exercises, in spite of no noticeable improvements. This morning something happened while doing finger blocking exercises. Like everyday I was trying pretty hard to get my finger to bend and suddenly it did. I got a weird feeling like the one described by Walker15 and I gained more than 30% of movement in both the PIP and DIP joints. I'm still far from normal mobility but I think/hope it will be easier from here.

Since I was inspired to keep trying by this thread,  I also wanted to share my own story. I figure the reason that there was only one person successful in breaking the tendon adhesion in the thread is due to a failure bias. It seems to me that people who didn't succeed are far more likely to write about it on an internet forum than those who did. The ones who succeeded are probably out climbing :-)

I don't know if it's recommended but I was taking the exercises pretty seriously and pushing it quite hard with some pain.

Good luck everyone and never give up!




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Avatar_f_tn
Well everyone i got caught up in a fight in a local lub tried to do the right thing and my little finger got shattered in 4 places on one joint nearest the knuckle. It all started last month but i had my op 3 days after the and needless to say... not enjoyable. Im now just over a month ago since it happened and im left with 3 screws permanently and little finger from middle joint to tip still pointing the wrong way. When making a fist (cant make fully) my little finger over laps the ring finger causing frustration. It dont look like my knuckle even exists anymore... i do try to pull the finger inwards to make a proper fist occasionally but this is only to stretch the joints. I dont yank it obviously just a little now and then. Im only 23 and as most of my life events use my hands feel bit lost in the world being a martial arts practicioner, gymnast and pianist aswel as archery and fishin for a hobby... iv been searchin all over web for recovery time for a wound such as this. But havent found much worth reading till this site showed up. All i wanna do now is focus on the OT which is annoying as its miles away....but atm do have alot of stiffness at times like cramp that just wont leave...the scar however healed nicely i dressed the stitches myself before having them removed i cleaned all the area properly. Then after the stitches were out after 24 hrs lightly washed it in a warm bath with a cotton bud... have to at this point recommend applying a little bit of savlon to area bout 3 times aday... really helped the dead/dry skin n nittin process fully healed in a wk... but i had read in an article that after broken fingers... swimming is a very gud way to regain mobility as the warm water loosens the muscles obviously but the repeated movement to swim against water is rated 13% faster recovery time so im guna check out sum swimmin soon. I dont recommend doin it OTT and deffo keep up with theropy but i hope my story can help someone else out there that feels lost for answers.... take care all.
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Avatar_f_tn
Hi, I'm 10 days after my tendon release surgery and just had my stitches out. Inhave been doing lots of very painful OT and have 90% movement when I use my other hand to bend my finger but the unassisted movement is only about 30%. Is there anything you can recommend doing from your experience post surgery? Many thanks.
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Avatar_m_tn
Unlike most of you guys, I broke the DIP on my index finger. It's been splinted for 7 weeks, and my ortho seemed shocked to discover I can't make a fist, as the PIP won't bend more than 90 degrees.  I tried to passively bend it while it was splinted, but I didn't start doing that until it had been splinted for 2 or 3 weeks.  The DIP is still broken, but the doc wants me to go without the splint most of the time.  I'm worried that if I do that, I'm going to end up with permanent mallet finger.  What should I do?  I've been working at bending the PIP, and I got a little range of motion back, but still not much mre than 90 degrees, and after reading here, I'm worried the DIP will lock up (if it hasn't already).  This is my dominant hand, so I really need my stupid finger.  Ideas/advice?
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992527_tn?1299208415
"seemed shock to discover"?? Really? I'd run as fast as you can from this moron. 7 weeks fully splinted and he's shocked?

How can the DIP still be broken? Was it not set properly to begin with?

An aggressive course with a certified hand therapist might be your only hope. If that doesn't work, you'll probably need surgery (joint contracture release surgery) and probably tenolysis on the flexor tendon. And then more OT with a CHT.

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Avatar_m_tn
I broke my pinky just below top knuckle and had a little chunk of floating bone as well as some twisting towards the outside. Had closed reduction with K-Wire fixation. Wires came out 5 weeks after they got put in. Doc told me to go to PT, but never went. Insurance didn't cover it and it wasn't cheap. Doc told me to keep using my other hand to move it. About a week after the K-wires were removed there wasn't much progress on range of motion. Then i was riding on a bus holding the handle with my hand with the broken finger. All healthy fingers were griping normally but broken pinky was sticking straight out in its locked position. Bus driver took a turn way too fast and I squeezed that handle for dear life. Right about then I felt a sharp pain in my knuckle and heard a very loud pop in the joint and it soon after really swelled up a lot. I thought it was trouble but the next day when I woke up I had gained about 40 degrees of motion so I figured I was on the right track. After that I pretty much squeezed on whatever there was around until i got more of those popping sounds. It hurt but my range of motion gradually returned. A year after the break I can just touch the top of my pinky (above last knuckle) the the bottom part (just above the palm) but there is some pain and stiffness everyday (particularly in the morning until i take a minute or two to force it to my max range of motion). But it still swells up a lot and I can hear some grinding and cracking going on in the joint when I force it beyond its now comfortable range of motion.

For other people who have had a similar break, what is a good result? I was hoping for better, but I am pretty much completely functional for all activities although there is the daily discomfort which is annoying. So it definitely could be worse. Also at this point i still constantly try to force it beyond its comfortable range of motion. It is just force of habit now since I did it pretty much non stop after getting the wires out. Does that still do any good at this point or am I just damaging stuff? I still feel some pain applying pressure to both joints or when creating resistance against me squeezing the finger closed and my grip strength in that finger is definitely lower. Will trying to continue to exercise grip strength there eventually help to get beyond that stage of pain when fighting against the resistance? I am just trying to figure if continuing to put effort into this would be of any help or if I should force myself to abandon the habit if its bad for my finger.

Lastly I saw you all mentioning regaining mobility while in a K-Wire. I was never in a cast, just gauze dressing, but whole finger was completely immobilized by K-Wires. How can you practice mobility when it has been completely stabilized like that? Doc never mentioned anything like that to me and I am wondering if I missed out.
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Avatar_f_tn
Hello all!
On august 18th I broke my 5th metatarsal (neck fracture). Went straight to the ER. There they confirmed it was broken, wrapped it in a splint with pinky and ring finger splintered together. That was on a Saturday and that following Monday I saw a hand specialist and he suggested surgery because of how it was broken. So I had surgery on that following Thursday and had two pins inserted through the skin into the metatarsal. He put a splint on that immobilized the pinky and ring fingers and then two weeks later I went back to make sure all was healing ok and then got a fiberglass cast on that immobilizedthe same way for two more weeks. Went back and got the cast off and pins removed. Weird experience but of course I was stiff but I expected that. The surgeon told me to start massaging that scar so that it wouldn't fuse together with the joint or tendons. At the time I wasn't thinking much of it and that I wouldn't have issues as long as i did what he said.
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Avatar_f_tn
Sorry, cut myself off short. Anyway... So he told me to massage that scar where the pins are and to make sure I stretch the tendons to get movement in there. Well it's been 9 days and I still can't straighten my pinkie. To hold my hand out flat pointer and middle fingers are fine of course. My ring finger I can straighten out the whole way but it's just barely level witht the rest of my fingers and my pinky just kind of hangs there. I can raise the first knuckle level with my hand but no further. The middle part of my pinky I can raise about a little and can't raise the tip at all. I've been flexing and stretching and massaging as much as possible and it doesn't seem to be working. I'm scheduled to go back Oct 18th (4 weeks after cast and pin removal) and I'm somewhat iffy about waiting another three weeks to find out what's wrong if I could have done something about it in the meantime...  
Thanks in advance :)
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Avatar_m_tn
Hi everybody I fractured my right middle phalange and finger in a oblique way in middle of August. My two options were to get surgery to make it straight or leave it and it'll heal crooked. I went ahead with the surgery and he placed two pins in order for it to become straight and heal correctly. 3 weeks after, i went to my first check up and he unwrapped my finger and pulled out the pins.

I was shocked and pretty pissed to see that the x-ray and my actual finger looked the same as it did before surgery! My OT told me the pins i guess was unsuccessful with making it straight and that my finger healed back that way.. So this whole time i have been going to PT and i have decided two weeks prior that i wanted to do surgery again to make it straight. He said he would have to re break my finger and he'd have to put a screw in order for it to heal straight and said everything would be okay. But as you can see above, he said that before and he was wrong BIG TIME!

So my surgery is tomorrow and i have just barely came upon this forum.. its so hard to find any information about this topic! But anyways after reading all of this I am thinking about cancelling the surgery due to this forum of people saying there is a HIGH chance of me not getting my ROM back at all.

The only and pretty much MAIN reason i want surgery is to make my finger straight again because when i make a fist it bends to my right about 15 degrees.

My range of motion is about 85% back and i can pretty much touch my palm.

I needed suggestions on my decision..  like i said my ROM is pretty good its just that my finger is still crooked! and after reading all of this people are stating that there is a very high chance my motion wont come back! and to top it off the re breaking the finger part sounds like it'll have a bad effect on me in the future..

I can still do surgery to it but for now i believe I'm going to cancel  the surgery for tomorrow. Reply back please on whether i should go ahead with the surgery or just leave my finger as crooked as it is with pretty good ROM.

Thank you all!
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Avatar_m_tn
Aaaaaah, been reading most of the posts whole afternoon and you made me scary, very scary indeed, people :-/

Hello everybody.

Sorry for my english, its not my first language, I will try my best to describe my problems.

I broke my fifth metacarpal 9 weeks ago, the doc put my hand in the cast for 6 weeks (the bone callus was not like it should be, healing process was slower, normally they put it in the cast for 5 weeks) and had no surgery.

Week and something after it was removed I went to PT to help me to give my pinky finger full movement again. The pinky was stiff in the metacarpal joint, very stiff. Before I visited PT for the first time I consulted this with a doc and he told me its probably fused extensor to the surrounding tissues and it is common, usually exercises are enough to get it back to normal, but I have to "work hard".

After ten visits at PT and exercises at home I can bend my pinky to cca 60 degrees down (on another hand more than 100 degress, maybe 120), when doing exercises for few minutes and "warming the hand up", its around 80 degrees. When I to put another hand on the palm under the metacarpal joint, the result is even better.

During those exercises (mostly making fist, rolling the fist on the desk) I felt pain in the area where the tendon is located, from the metacarpal joint to the wrist. I guess it was a sign of freeing the tendon from surrounding tissues because after this pain there was always some progress in bending the finger.

But in the last week I've made no progress at all. I feel little pain arround the metacaral knuckle and between the metacapral knuckle and PIP joint when pushing my pinky to the palm. But the movement is not free like on another hand, I feel theres something that restrain the movement - fused/attached extensor? It looks like that but theres something weird - when doing exercises for 5-10 mins in warm water I can bend my finger passively 80 degrees and when another hand put in the palm under the metacarpal knuckle, I can bend it more than 90 degrees and can touch my palm. Cant stretch my finger in this position though (I can on another hand) and it hurts between the metacarpal joint and PIP joint little (I am sure its the tendon).

When making a fist durting the day or exercising all the time (when watching movie, walking etc) the limitation of the finger is very small (but still limited, I feel it, plus it hurts a bit) but in the morning it seems like there will be no way than a surgery, I can bend the finger only around 40 degrees and it takes few minutes to get it back to "my normal".

I am very happy I can make a fist and use the hand again, but still, I would like to use the hand (its my dominant) like I did before. But after reading your experience...I am not sure I want to take the risk. And have no idea if it the tendon is really fused when I got so great results after proper exercises in warm water. Maybe if it wasnt fused I would be able to do full range of movement like I do with another hand?

Dont know what to do. Ask really good doctor to help me, or accept it and live with it? I feel limited, its better than it used to be weeks ago but still its not perfect. Is the risk of having problems like some of you do after tenolysis between PIP joint and metacarpal joint as big as tenolysis between PIP and DIP?

I was searching on the net a lot and did not find the answers, only this discussion gives a lot of info to a reader, thats why I am asking here.

Thank you for reading my long post and for any answer.
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Avatar_f_tn
I can't remember all the details but wanted to say something in regards to this set of comments. I too broke my pinkie finger. I had it splinted and no surgery. I went to a wonderful OT who specialized in Hands which was great. When I first started OT, I could not bend the finger very much and there was a lot of pain and achiness in that joint. I wondered how it would ever heal. I finished therapy and still had pain but there was nothing left to do. My finger would ache terribly when cold or when in one position too long. It would sometimes wake me at night. I did a lot of excercises and held it bent for increasing lengths of time. After a while I forgot about it and time went on...and I can happily report that even tho its not perfect, I barely notice it after a year from the date of injury!!! I really expected to never be right with this hand but I am! I recommend heat therapy and working the joint when warm as that was when it was easiest to move it.
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Avatar_m_tn
Definitely, people have to be patient and even after months still do some exercises.

Broken pinky (or near area) seems like no big deal, its just a pinky, but its quite the contrary,we need it more than we think and getting it back to normal (or near to normal) takes not weeks, but months.
Even the metacarpal bone is properly healed after half a year, not when the cast is removed. And remodeling itself takes years!

This weekend, after I posted my last post, I've done some progress again and it seems my tendon is not adhesed anymore. But my pinky still doesnt have full ROM. Whats good, it doesnt limit me in my everyday life. I spent around 3 hrs of exercising, making fist, moving pinky, straightening it etc every day last week and it made a difference!

Dont be fool and dont think your fingers will be ok in weeks, or even in days, it takes months! Not months of doing nothing but doing right exercises. Be patient and do not give up too soon! It is your hand and you need it, dont cheat.

First weeks and month or two after the cast is removed is crucial in therapy (its true good PT can do miracles even after half a year of immobilization but it hurts much more and is difficult much more), do as much as you can. When you watch tv, squeeze a foam ball, make a fist, do exercises from "How To Rehab Your Hand After An Injury, Boxer's Fracture, or Surgery" video (put the text in google), when working with computer, use your healthy hand for using mouse and do these exercises all the time.

These can be helpful too (you need just pics, understaning the text is not necessary - just do not do anything that hurts much, exercises should hurt, especially in the first few days or week after long period of immobilization, but do not push it too far, your tendons and tissues are not prepared yet):
http://www.ortopedie-traumatologie.cz/Rehabilitace-prstu-ruky

Good luck everybody!
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4408781_tn?1354142990
I broke my right pinky 7-30-12  I had no insurance so I made a splint and ice it down for two or three days. and keep working at my on pace, Pain was not to bad. Arter a month I started having some pain, I told my self it was just healing and with more time it would get better. It is 11- 28 -12 and it tender to the touch and humpted up in the joint closest to the hand. Is there a chance of seeing a doctor now to have some thing done are is it to late. thanks
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Avatar_m_tn
i had a similar accident, going over the handlebars and leaving my right pinky behind the break. 5 screws and a plate right in front of my PIP running the length of my pinky.

still pretty swollen and only goes straight when using force but i am optimistic, its been about 5 months but the therapists and dr both say as long as i sleep in the finger splint holding it straight it will continue to straighen out. i can make a fist to about 80% the dr says that will come slowly and i have continuously been seeing improvement. so we'll see.

how is yours now?
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Avatar_m_tn
My 16year old daughter broke her right pinky finger at the pip joint; small bone chipped off and has caused joint to not meet up correctly.  When this first happened back in November we were told by the Orthop to buddy splint it to the ring finger for two weeks.  We did and it seemed to get better;due to illness and other conflicts we weren't able to get back to the doctor till January.  They xrayed again and said it hadn't healed well and suggested surgery to insert pin to hole chip and joint in place.  She had surgery on 1/23; was in a soft hand cast for 10 days then a splint for another week before starting OT.  Just went in for another xray as a follow up with doctor last night and was told that the chip is now out again that the pins didn't hold and we are back to square one but with 2 pins now in her bone.  We are very upset and are one the fence about doing the surgery again; she is a varsity softball and travel team player so she wants to just deal with the pain so she can play.  Between the cost of the first surgery that didn't work and the concern that a second surgery won't either I have a decision to make on whether to let her make the call.  I asked him if we could wait to see how it proceeds and maybe look at if necessary having surgery next fall and he said it would be too late.  We of course are a little concerned about his abilities and are considering getting a second opioin.  Some people are saying it is just her pinky so if she is ok with the pain and she can move it then try to see what happens.  

I'm just worried it will get worse.
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hey guys,
i dislocated my index finger recently.. for which it had to be operated.It was the joint at the knuckle.. after surgery my finger was kept bent for 3 weeks in a cast.. well not a cast,more like a bandage that didnt permit movement.. the doctor removed it today(after 3 weeks).. the finger was swollen and wasnt moving at all..now it moves very slightly.. i was told to try and bend it a bit at home.. im going to start physiotherapy after 2 days.. but the posts here really got me worried.. how much should i force my finger to bend.. will too muhc motion be bad.. should i apply ice for the swelling.. and what are the chances of getting back normal range of motion..
its my right hand so im worried.. please reply.. thanks
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Avatar_m_tn
I dont know if my pink finger was broke or deslocated and its been 12 years, since then my pinky never been straight anymore, i know is been many years but when i try to pull hard and its still hurts. right now i dont know what to do, maybe surgery or something?  help please and sorry my english.
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