Jammed Finger May Be a Bigger Deal Than You Think

Experts call the finger’s middle joint “unforgiving” when injured. That’s why a digit jammed by a hard-thrown ball or smashed in a car door may be more than a “no-big-deal,” says hand and upper limb orthopedic surgeon and author of Healthcare from the Trenches, Dr. Alejandro Badia. Dr. Badia notes that this middle joint – the proximal interphalangeal joint or PIP – is what usually absorbs much of the impact from a blow and is most susceptible to trauma.

 Dr. Badia adds that “”jammed finger” is a terrible and nonspecific misnomer. Using that term only describes the perceived mechanism of the injury, not at all the actual diagnosis like a fracture, dislocation or ligament or tendon injury. Oftentimes, it’s difficult to determine immediately whether the finger’s collateral ligaments have been simply overstretched or sprained by the injury or whether the joint has been dislocated or even fractured,” Dr. Badia says. The collateral ligaments are located on either side of the PIP and help support it. Dr. Badia warns that delays in diagnosis and treatment by an orthopedic specialist can lead to complications, such as fibrosis and stiffness, reduction in the finger’s range of motion, degenerative arthritis of the joint, and finger-joint deformities, which may be difficult to later repair and can interfere with a person’s grasping abilities. In fact, scientists indicate the PIP provides as much as 85 percent of the motion required for gripping.

 “Time is of the essence in seeking treatment,” says Dr. Badia, an expert in care of the hand, wrist, and other upper limb joints and founder and chief medical officer of the Florida-based Badia Hand to Shoulder Center and OrthoNOW”. “Too many times, patients consider a finger injury as minor and avoid contacting a physician until days – even weeks afterwards – when pain and swelling persist in the joint, and the finger becomes increasingly stiff.” This is particularly true of athletes – or their trainers — who delay care or seek inappropriate treatments that can result in irreversible loss of motion and finger abnormalities, like swan neck deformity in which the finger becomes bent towards the palm of the hand, say authors of a report published in a 2018 issue of the journal Hand Clinics. 

With the exception of the thumb, each finger comprises an intricate network of three bones (phalanxes), three joints, and upporting tissue, ligaments, blood vessels and nerves. “Diagnosing and treating injuries anywhere along this system can be difficult enough even for the experienced orthopedic specialist,” Dr. Badia says. “That’s why seeking treatment for a finger injury from hospital emergency physicians or family doctors unfamiliar with the complexities of the hand is not a recommended route of care.” 

The PIP is a “hinge joint” that allows the finger to flex and extend. It is located between the knuckle (the metacarpophalangeal joint) and the distal joint at the fingertip. A blow or smash directly on the finger or stress unexpectedly placed on an extended finger can cause a wide diversity of PIP­related injuries.