Finger joint injury

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What is a finger joint injury?

The small joints of a finger allow it to bend into the palm. They have tough ligaments at the front and sides to keep the joints stable. 

The volar plate sits on the palm side of the joints. It stops the finger being overstretched backwards (hyperextended). Collateral ligaments sit either side of the joints and stop the finger being overstretched side-to-side.

What causes a finger joint injury?

The ligaments around a finger joint are most commonly injured when stretched beyond their normal range of movement.  

This might happen during a fall or a direct hit from an object e.g. a ball.

What is a volar plate injury?

The volar plate is the tough ligament on the palm side of a finger joint. It gets stretched as the finger bends backwards. Sometimes it stretches so far that it comes off the bone or even pulls a piece of bone off with it.

In severe cases the bones go out of joint (dislocate). This usually means both the volar plate and at least one of the collateral ligaments are torn.

The middle joint of the finger (proximal interphalangeal joint, PIPJ) is the most common joint to have a volar plate injury or dislocation.

Before After

First aid

– Ensure your safety

– Remove any rings from the affected hand

– Lift your hand above the level of your heart to reduce swelling

– Apply an ice pack to the injured area. This might be a bag of frozen peas wrapped in a tea towel

– If there is a wound, clean with soapy water and apply a dressing

– If allowed, take a simple painkiller such as paracetamol or ibuprofen

Seek urgent care if:

– the finger looks deformed, it might be out of joint or broken

– there is numbness or pins and needles in the fingertip or the finger now looks white or purple

– there is a wound over the injured joint

– your movement of this joint is poor, even after your first aid and rest

Self-care

The most common problem is a sprain of the volar plate. It usually needs rest and protection from function and help to reduce the swelling.

The finger can be ‘buddy taped’ to the finger next to it for support and protection of the damaged structures. 

If the finger is hard to straighten, you can use a lolly stick with tape to gently hold the middle joint straight for a few days or just at night and rest periods.

Hand therapy advice

It is important to keep your finger moving otherwise it will become stiff. Within a couple of days of injury, start exercising your finger. At first, do this every 2-3 hours with the buddy tape on. The uninjured finger helps the injured finger to move.

If you were given a splint on the back of the finger at hospital, then the top 2 straps of the splint will need to be loosened for you to perform the exercises.

  • Week 0-3
  • Week 4+

Use the Hand Therapy app for specific exercises

Exercise 1: active finger gross composite extension/flexion

Exercise 3: active isolated tip joint flexion

Exercise 4: Active isolated middle joint flexion

If after 3-4 weeks your finger remains stiff then you should progress to doing the following exercises:

Exercise 6:  intrinsic gliding/blocked extension

Exercise 8:  passive finger flexion into a fist

Exercise 9:  passive finger flexion into a hook

Exercise 11: passive finger extension, middle joint (gently to start with)

Exercise 12: passive isolated tip bend

Recovery

The speed of recovery depends on many factors including the severity of injury and patient factors. 

Most simple ligament sprains return to normal within 3 months. Many patients find that the joint remains mildly swollen and stiff for many months. You might find cold weather makes it worse.

If you have damaged a collateral ligament you might need to avoid twisting functions like opening bottles with that finger for longer until the ligament is fully stable again.

The details below are for a typical patient with a medium severity injury.

  • Driving
  • Work
  • Sport

You can drive again once you can take full control of your vehicle without distraction and perform an emergency stop. You should discuss your injury with your insurance company and take responsibility for your own safety whilst driving.

Office work can be performed once you feel comfortable. Manual work can be performed after 6 weeks following the injury as long as the joint is stable again.

You can return to non-contact sports once you are comfortable. Contact sports can be restarted after 12 weeks.

Author: Jessica Steele
Review: Matthew D. Gardiner
Hand therapist: Hayley Fay, Sarah Mee, Nikki Burr
Last review: 20 April 2020
Next review: 20 April 2021

Disclaimer

As a service to our readers, My Injured Hand provides information on conditions. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician

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