finger tendon injury... need advice
My doctor told me I tore my flexor digitorum profundus of my ring finger. He said I will no longer be able to move my first knuckle on this finger but I would still have most of the important function of my hand and finger. He said surgery is possible but not vital for this type of injury. He actually discouraged me from getting surgery. I would just like to get a second opinion. Right now, it's been 4 months since my injury and my whole ring finger is still a bit swollen. I can bend the 2nd knuckle but not completely. The 1st knuckle is stiff and immovable. Every time I wake up or don't use my hand for a long period of time, my ring finger becomes very stiff. My doctor said I need to exercise it everyday with a clay mold and a hand excerciser to gain more movement and decrease the swelling. Would you recommend or discourage surgery for this type of injury? Also, do you think there's even the slightest chance that it may not be ruptured completely, even though I really can't move it and it's been stiff ever since the injury. Thank you so much for your time and help.
Comments
We see tendon injuries all the time and I would recommend getting the surgery. I would recommend seeing a a doctor that specializes in hands and not an ordinary orthopedic. One thing to remember with the surgery is that scar tissue can cause issues, so if you do get the surgery, make sure to see a hand specialist afterwards to help reduce the scar tissue formation.
There is a very slight chance you did not fully rupture your tendon, but if you can not move your 1st knuckle (MP joint) you most than likely ruptured the tendon.
The longer you go without getting it fixed the harder it will be to fix. Think of your tendons as rubber bands. When one breaks, it is pull towards the forearm. This makes it harder to find the end of the tendon to repair it.
Keep up with your exercises till you see your doctor. You don't want that finger to remain stiff.
I was misdiagnosed 6 months ago with torn DIP ligaments instead of a complete rupture of the flexor digitorum profundus tendon. I just got back from a consultation with a hand surgeon (after getting several "2nd opinions" from different general orthopedic surgeons). He said that in order to restore some movement to my DIP joint, he would have to graft a tendon from my wrist to reconnect the torn FDP which has just retracted to the PIP joint. I asked him if he would highly recommend the surgery since all of the orthopedic surgeons I visited discouraged such surgery because of the "scarring" that it would create. He said that he would recommend it to me because I was still relatively young and may require mobility to my DIP joint for my activities, although the mobility that may be restored would definitely not be 100%.
I would really prefer to gain back some mobility for my ring finger. However, I am scared that the "scarring" may affect my PIP joint which thankfully still has about 80% mobility (due to the swelling that never subsided), or that the surgery may yield no significant improvement on the DIP joint. I already discussed these concerns with the hand surgeon. I would say that he is a man of few words and he didn't really go into detail explaining what I wanted to know. He just basically said that although movement would be restricted due to the scarring that it would cause, at least I would have the use of these joint again. My parents, who are very much supportive of me, still doubts that surgery would be beneficial to me since an orthopedic surgeon who is a very close family friend discourages it. I was hoping to get any sort of opinion you might have with my case. Thank you so much for you time.
I would recommend going to see another hand surgeon and get yet another opinion. I tend to discourage people to see an ordinary orthopedic surgeon for hand related injuries since the hand is so specialized.
While scarring is a definate possibility, hand therapy can help reduce the scarring if you see them right after surgery. You will definately need to weigh the pros and cons. Pros being the movement you could possibly gain and Cons being the scarring and possible no improvement in motion.
Go see a hand surgeon that will sit and actually discuss the surgery with you and review his thoughts. You don't want to see a surgeon that will keep you in the dark regarding your surgery and his opinions on that surgery.
Let me know where you live and I may be able to help. I do know some good surgeons in the PA/NJ area.
Dave
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Joined: 2008-08-28