The middle joint of the finger (known as the PIP joint) is the most frequently injured joint of the hand. Unfortunately finger injuries are frequently dismissed as just a ‘jarred’ finger or inappropriately treated. There can be long term complications associated with delayed treatment or mismanagement of PIP injuries such as recurring dislocations, chronic and flexed deformities. Unfortunately, these chronic issues can have significant impacts on your hand function and daily activities.
The PIP joint is a very complex structure requiring early assessment and diagnosis to provide patients with their best outcomes. Studies indicate that outcomes are significantly improved when they are treated early post injury, within 4 weeks.
PIP injuries include;
Ligament injuries:
Range from grade 1 tears (the true jarred finger) through to grade 3 full ligament ruptures and joint instability. Depending on the severity will depend on your best treatment. Grade 2 & 3 tears often require 2-6 weeks of splinting which must include exercises to prevent stiffness. Some severe ligament injuries may require surgical repair
Avulsions fractures:
Frequently a piece of bone where the thick ligament on the palm side of the PIP joints attaches can break off. These fractures are often very small but poorly treated. They are usually best treated by hand therapy unless the fracture is too large or unstable, they would require surgery
Dislocations +/- fractures:
Most stable finger fractures can be treated with custom splinting and hand therapy. Rarely will you have a finger fracture without complex soft tissue injuries. It is important to remember these soft tissue injuries won’t be seen on x-ray, so if you get the ‘all clear’ all might not be as it seems!
So next time you suffer a ‘jarred’ finger on the court or field, consider if there might be more to it? Early assessment and treatment for fingers is essential for good outcomes.
Content provided by Kate Cameron, Practitioner of Hand Therapy