Smashed a finger - need a doctor?
September 14, 2017 12:07 PM

I know that YANMD, however, I'm trying to decide if one is really needed.

Tuesday afternoon a plexiglass partition guillotined down onto my ring finger, right at the nail bed. Swelling, bruising, and pain promptly followed. I'm assuming that the tip of my finger is likely broken, but I'm also stubborn, and don't want to waste a trip to the ortho if I don't have to. Nail is not broken and remains intact, but there is a decent amount of bruising under it. From what I can gather, even if the tip of my finger is broken, its most likely all they will do is give me a finger splint and send me on my way. I have already been using a splint since Tuesday night, so it seems silly to go in for smashed finger. But then again.... I don't want to lose function in the future if I can help it, obviously. Does anyone have experience we these types of injuries? Are they going to laugh at me if I go to the ortho?

Here are some pictures of what it looks like today. Swelling has gone down, and I think the last one is an example of how far I am able to bend it at this point.
posted by Quincy to Health & Fitness (11 answers total) 1 user marked this as a favorite
As someone who has had a finger stepped on by a 1200 lb shod horse standing on concrete and has not gone to the ER, I'm thinking I personally wouldn't bother. Son in construction dropped a 300 lb granite slab on the tip of his index finger. Both accidents occurred 10+ years ago. Both involved lots of blood and gore, and the swelling and bruising was down into the hand. That doesn't make either of us smart, but neither of us have had issues since then, other then an ugly flat finger on the part of my son. I've got arthritis and Heberden's nodes on several other fingers, but that one is fairly smooth. Go figure.

I am not your ortho, Y pain tolerance and MMV.
posted by BlueHorse at 12:22 PM on September 14, 2017


You asked the same question a year ago, when you had a serious injury and you most definitely did need to go to a doctor.

Broken finger >> see somebody who knows more than you do about broken fingers, who can look at the finger intelligently, and make an intelligent and informed recommendation.
posted by JimN2TAW at 12:30 PM on September 14, 2017


As a musician (and a construction worker), I'd see a doctor. I expect high precision performance from my fingers. Toes, not as much - I let a broken toe heal on its own and it was fine.
posted by cnidaria at 12:32 PM on September 14, 2017


I am not a doctor, this is not medical advice.

What concerns me most is how much bruising is going up your finger. Intra-articular (aka joint) damage is bad and frequently requires immediate intervention (I had destruction of my proximal interphalangeal joint in my dominant hand's ring finger; in a system somewhat infamous for long surgical wait times, I had surgery 2 hours after meeting a specialist). Tendon damage is also bad. I will also note that immobilization of the joint is not great for fingers and needs to be done carefully (at certain angles depending on which bone is broken) and for less time than most fractures need. Plus, hand fractures tend to 'move' on their own because of all of the tendons etc. pulling on them.

The fingernail bed bruising is probably fine and probably won't require intervention unless it hurts too much, in which case you might need someone to pop a hole into your nail to 'vent' the pressure from the blood. The nail might fall off completely, however.

Personally I'd pop in for a quick assessment, especially since you call yourself stubborn. If it's nothing, you'll find out quickly and you can ask for advice from your doc about when he or she wants people to come in for a check, for the future.
posted by flibbertigibbet at 12:40 PM on September 14, 2017


Hi, it's barchan-never-goes-to-the-doctor. And who has probably broken almost every finger and toe at some point in the last 30 years. And who has nails that just don't grow any more or weirdly because of it. And weird shaped fingers. And toes.And who personally probably wouldn't go to the doctor for what you have, would just shrug it off with an "eh". Who once hiked around steeped terrain for about 4 days on a broken foot because I just shrugged it off, causing some pretty serious damage. And even 3 years ago would have said to you, ah, skip it, that doesn't look bad at all!

AND WHO DEEPLY REGRETS ALL THAT NOW.

I've also got fingers and toes that don't quite work the same anymore. Look, I've had broken fingers that I got away with not going to the doc and I did pretty much as you described. Maybe that's what you have. It might not even be broken, just badly bruised or sprained. But I have fingers/toes I'm really sorry I didn't, one of which I've had to have re-broken, and another they had to put a pin in later. And the older I get, the more some of those old breaks are starting to keep me up at night with arthritis and I'm still in my fucking 30s. So maybe I didn't get away with it.

They're not going to laugh at you - they're professionals, and they're there to put their expertise to work. You're not going to bother them either - they'll be glad you didn't shrug it off. You don't know what kind of injury you have, and maybe it's fine. They don't know what kind of injury it is, either, and won't until an experienced person examines it fully. Odds are they'll do exactly as you said, but you just don't know.

Don't mess with your fingers - you want them to work right forever. Go to the goddamned doctor. Please don't be stubborn, tough it out me.
posted by barchan at 12:44 PM on September 14, 2017


I don't know, but the above seems reasonable.

More generally, do you have a primary-care provider you trust not to overtreat and who you can call, describe symptoms, and ask, "Should I come in?" If so, call that person.

If not, after you've dealt with the finger, try to find that person.
posted by Mr.Know-it-some at 1:00 PM on September 14, 2017


IANAD

Smashed my finger very similarly in a car door once. I ended up with a nasty subungual hematoma. You're almost guaranteed to have the same. You can live with it, but it's pretty gross and uncomfortable. I didn't go to a doctor, either. The nail eventually healed, but to this day it grows kind of funny.

Are you experiencing any kind of neurological symptoms? Tingling, numbness, pins and needles, shooting pains up the arm, or anything like that and I'd see a doctor who understands neurological injuries to peripheral extremities really well.

Otherwise, call a good office in your area and see if they have some advice for you over the phone.
posted by chatelaine at 1:01 PM on September 14, 2017


Do you have health insurance? If so, I vote you should go. What if the joint is busted and you're never able to bend your finger again? What if it aches every time it rains? etc. etc. Do you really want to risk living with that? Fingers are important.

And I know it sucks how medical professionals sometimes make us feel silly for coming in. It's worse for women since so often we're not taken seriously. Go now while it's still all bruised and swollen.

If you still can't bring yourself to go, at least call the 24 hour nurse hotline you probably have on the back of your insurance card. Nurses are almost always really nice on those. They'll ask you a lot of questions, and then make a recommendation about whether to go in and what you can do for home care too.
posted by purple_bird at 2:33 PM on September 14, 2017


It's probably fine, but maybe not! Go get it checked out so you know for sure.
posted by Anticipation Of A New Lover's Arrival, The at 2:39 PM on September 14, 2017


Does your health insurance offer a 24-hour nurse line? If so, a call to them is definitely in order and they would be better-equipped to advise you than us well-intended and overall quite knowledgeable folks - in many areas but not (apparently) orthopedic surgery - on AskMetafilter. If you don't have access to a 24-hour nurse line, I'm with team wait-and-see.
posted by DrGail at 2:48 PM on September 14, 2017


I went to the ER for a broken fingertip but I could feel the pieces moving around in there when I flexed it. Can you feel that happening? I would definitely go if you can feel that happening. I was lucky I didn't need surgery on the stupid tiny thing.
posted by teslacoilswoah at 9:09 PM on September 14, 2017


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