Pinky fix
November 25, 2008 10:13 AM   Subscribe

I broke my finger four years ago this month, and it's still a mess. Is it too late to get it fixed right?

I broke my pinky finger in a bike accident (i bounced off the front of a dump truck). The fracture was diagonal, meaning the fracture was not terribly stable. My doctor decided against putting pins in it, hoping to leave me without a scar. But instead he left me with a large unsightly bump on the left side where the pointy part of the diagonal fracture sticks out. I did physical therapy to get motion back, that's not really my complaint.
I experience numbness in that finger on occasion. And now that it's getting towards winter I get aches and pains.
I have also lost some weight since then, which may also explain some of the bump's protrusion.
Anyway - is there any point in going back to him and having pins put in? Would that even be possible after four years? I realize you are not my doctor. Should I go back to him or go find a new doctor to deal with this altogether.
Or is this just something I should deal with for the rest of my life.
posted by chickaboo to Health & Fitness (9 answers total)
anecdotal evidence: pinkies are tricky. friend of mine shattered his in a bike accident, too, got it fixed pretty well, it hurts twenty years after the fact. your bump should be part of the mechanism that your body used to fix the fracture, and hence it's probably there to stay. anything else, you should ask a doctor. sorry and good luck.
posted by matteo at 10:42 AM on November 25, 2008

I broke my bird finger on my right hand when I was 15 and due to the fact that I was grounded and not supposed to be doing what I was doing when I broke it, I failed to mention it to my parents. We never got it set or dealt with at all. It was nicely crooked with a large lump. At 30, when it started hurting due to cold and some numbness, I went to a hand surgeon who chiseled off the lump and made sure that all the nerves were not pinched by the calcium deposit that had formed.

It's fine now, straight and lumpless and never hurts.

So yeah, it's totally possible to have it fixed, although I doubt they will pin it. Most likely your doctor will remove the bump and may rebreak it and fix it that way.

Good luck.
posted by teleri025 at 10:42 AM on November 25, 2008 [1 favorite]

I'm not a doctor but I've had more than my share of sports injuries.

Any bone can be surgically re-broken and re-set. If there's just a small fragment sticking out, it can be shaved down. If the numbness is only occasional, then nerve damage is unlikely but rather the nerve might be pinched by uneven bone or by scar tissue.

As for aches and pains, the whole thing about "damp and cold" exacerbating bone / joint pains seems to be a confirmation-bias type of myth. Numerous studies have found no actual correlation.

Anyway, only you can be the judge of how worthwhile it is to get more surgery.
posted by randomstriker at 10:42 AM on November 25, 2008

Putting pins in won't fix anything, it's already set. Most options all include surgery, and/or re-breaking your finger.

Explain your issues to your doc, does he know you're in discomfort? What happened during the follow-up visits, is this a known issue or does he think everything healed OK?

Once you get his opinion then you can get a second opinion. You'll also want to find out what insurance will cover, this may end up being a case of 'discomfort & deal with it or spend $$$'.
posted by jpeacock at 10:43 AM on November 25, 2008

IANAD, but on the basis of a conversation with someone else with a similar injury recently it's likely that it can be fixed, but the chances are it'll take a lot more work than would have been necessary when the break was fresh. You're now dealing with fully-healed bone that may well need to be re-broken and pinned.
posted by le morte de bea arthur at 10:44 AM on November 25, 2008

well I guess yeah I'd be concerned about the $$ as well. I'm sure insurance might have covered it four years ago but now? and plus I'm sure whatever I had done would require more PT which is also not cheap.
posted by chickaboo at 10:49 AM on November 25, 2008

chickaboo, my insurance covered the surgery on my 15 year old injury because the surgeon deemed it "medically necessary". It may depend on your doctor, but if you make enough noise about how it hurts and how it bothers you, they most likely will find a way to get insurance to cover it.
posted by teleri025 at 11:19 AM on November 25, 2008

Insurance *may* cover it. You are having symptoms that are uncomfortable and (possibly) related to it. You may be surprised.

Find a new orthopaedic surgeon that specializes in hands and go for a consult. Explain the symptoms and what the other physician did. He will probably want the old records, ask when you make the appt..

It is not uncommon to get arthritis after a fracture. But this sounds like it could be more. I'd get it checked out if it were me.
posted by 6:1 at 11:21 AM on November 25, 2008

Speak to a plastic surgeon (or whatever type of doctor deals with hand surgeries in your area: my surgeries were both performed by plastic surgeons). I had to have a second surgery on my index finger just over 3 years after the initial injury and surgery, to repair a badly done first surgery. I was in increasing pain as time went on, and 2 years later decided to see a specialist. I requested surgery in the summer only, which is why it took a year.

My index finger was bent so that it overlapped the ring finger on the same hand, but I had full motion. What they needed to do for me was to actually cut out some bone, then pin it. (I could have had a joint replacement, but for various reasons I elected not to.) My arm to the elbow was immobilised for 2 months, and I lost all motion in my finger. I also have a very obvious scar on my finger -- but it only overlaps a bit with the middle finger (I point using two fingers, because otherwise no one knows where I'm pointing), and I'm only in occasional instead of constant pain, so altogether I am pleased with the second surgery.

Now, you're talking about a different finger, and what appears to be a much more minor injury, but you need to figure out what you are and aren't willing to give up for a surgery. I knew that it was highly unlikely I'd have any use of the finger, and that I'd need to relearn to type, write, etc (this did not take long); I cannot do intricate tasks for more than about an hour at a time. Your doctor should be able to tell you what can be done to help, what the chances are that you will have different results, what some of the other effects will be, what the risks of negative results are, etc.

Are you pleased with what your initial doctor did? Were you appropriately warned of the risks of different choices (pins, no pins, etc)? If so, go back; if not, find a new doctor to look at your hand. Asking doctors what your options are now does not obligate you to do anything at all, but at least then you know what the choices are. If you have pain and numbness, surgery might be covered by insurance. I'm in Canada, and mine was covered by the government as it improved my functioning.
posted by jeather at 11:41 AM on November 25, 2008

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