What is Jammed Finger?
Jammed Finger is a condition wherein the finger suffers from an impact injury causing pain and swelling in the area. The condition tends to be very painful and requires further management. Jammed fingers relatively heal quickly when fractures are not incurred. Jamming of the fingers is more common, although affectation of the toes may also be experienced.
When fractures are present, the healing time lengthens to one to two weeks and may require more extensive treatments. Jammed finger is a layman’s term for the axial blow on the proximal interphalangeal joint or at the tip of the fingers.
The occurrence of jammed fingers is more common in sports involving ball-handling such as volleyball and basketball. However, jammed fingers can be effectively prevented through training and special equipment in the fingers. Any injury in the proximal interphalangeal joint can lead to permanent disability when left undiagnosed and untreated.
The proximal interphalangeal joint is an axis joint that can perform range of motion from 0 to 120 degrees. The lateral stability of the joint is supported by the thick collateral ligaments. The injury in jammed fingers involves some degree of hyperextension in the area with longitudinal forces or compression on the tip of the fingers.
The volar plate forms the base of the joint. The joint also have extensor and flexor tendons that allow for various range of motion of the joint. The most common reason for jammed fingers is the axial blow or longitudinal compression on the joint with additional hyperextension of the extensor tendons that may result in dislocation of the volar plate. The injury may also affect one or more fingers, but the middle finger is most commonly affected.
Symptoms of Jammed Finger
Jammed fingers lead to various symptoms such as:
- Tenderness on the proximal interphalangeal joint
- Swelling or edema on the top of the finger or fingers
- Limitation on the range of motion of the proximal interphalangeal joint.
- Loss of active extension of the finger
- Significant pain on the area
- Numbness or tingling sensations in the finger as a sign of neurovascular compromise
Causes of Jammed Finger
Jammed finger can be caused by any activities that may involve longitudinal compression on the interphalangeal joint. These activities involve the use of the hand to handle things such as:
Basketball, volleyball, baseball, softball, and other sports may cause accidental longitudinal compression of the proximal interphalangeal joint during athletic activities. These causes are usually not preventable because injuries may happen during any sports events.
Accidental falls may also lead to jammed finger in cases that the fingers meet the ground first in a longitudinal manner, hyperextending and breaking the extensor ligaments in the fingers.
Diagnosis of Jammed Finger
Diagnosing jammed finger involves radiographic studies as well as physical examination to evaluate the condition of the patient and differentiate it from fracture of the fingers. These diagnostic tests include:
X-rays are very essential in diagnosing the condition and differentiating it from finger dislocations and fracture. X-ray images will reveal the exact damage on the proximal interphalangeal joint such as dorsal dislocations, volar plate sprain, collateral ligament injury and Boutonniere deformity. Radiographic studies involve the taking of lateral, anteroposterior ad oblique radiographic images of the digit. Radiographic studies are able to identify subluxation, dislocations and fractures.
Physical examination is usually done after radiographic studies to prevent further injury in cases of fracture or other conditions. Physical examination involves assessing for edema, swelling and tenderness in the area. The neurovascular status is also assessed by checking the skin temperature and presence of paresthesias or tingling sensation in the area. Finally, the range of motion of the joint is assessed, which may reveal loss of active extension of the joint.
This involves the injection of local anesthesia in the hands and fingers to reduce pain for more accurate diagnosis because pain may sometimes impede further assessment.
Treatment of Jammed Finger
How to fix a jammed Finger is a question from many athletes and people experiencing the condition. Treatments focus on stabilizing the joint and reducing symptoms. Rehabilitation is also needed to regain the optimum range of motion of the joint. Treatments include:
Ice compress or cold compress is placed over the injured joint in the finger to reduce pain and swelling. Cold temperature numbs the area to minimize pain. Ice packs are placed over the area for 15 minutes at least twice a day.
The finger is elevated during the acute stage of injury to improve venous flow and minimize swelling.
Immobilization of the finger with the use of splints and tapes are essential to prevent further injury to the joint. Immobilization also allows for rest during the healing process.
Physical therapy and adjunct managements depend on the specific injury to the finger. These include:
- Volar plate sprain- This requires taping to adjacent fingers (buddy taping) to immobilize the area. Early range of motion exercises should also be employed.
- Collateral Ligament injury- This also requires buddy taping with early range of motion institution. Buddy taping may be placed until pain subsides.
- Dorsal Dislocation- this requires close reduction of the joint by orthopedic physicians. The joint also needs dorsal splinting with 10 to 30 degrees flexion of the joint. Splints are placed for 2 weeks to ensure complete healing. Aluminum foam splints are used. ROM exercises are employed after the initial treatment.
- Boutonniere deformity- This requires full extension splinting for 6 weeks. After the 6 weeks splinting, ROM exercises are instituted.
Medications are also given to patients to relieve pain. Medications may include non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen or narcotic analgesics such as hydrocodone and codeine.
Surgery is employed for dislocations that cannot be reduced using a closed technique. Surgery involves an open reduction surgery to return the normal positioning of the joint. Jammed fingers with associated fractures may also require internal fixation of the bones. Chronic deformities may also require surgical approach.
The healing period for jammed fingers usually takes 2 to 6 weeks depending on the severity of the injury. Complications for untreated injuries may involve persistent pain and loss of function. There will also be stiffness and weakness of the joint.
Jammed Fingers VS Broken Finger
A jammed finger does not involve break in the bone or the joint itself. In broken fingers, fracture is the main characteristics and may also involve the break in one or more phalangeal bones.