Problem with middle finger right hand

[6tee7]

I was hoping someone could point me in the right direction1

About 2 years ago I injured my right hand at work. I was in a ceiling and stumbled, to save myself falling 4 metres I grabbed at whatever I could which was a celing suspension wire. It stopped me from falling but my whole body weight was taken on the inside of my middle finger and seperated it from the index finger. At the time I was grateful for not having to replace the clients ceiling but after seeing a hand physio and a " hand surgeon" it is no better.

My symptoms are : Can't make a fist
Middle fingeris less flexible than it was
Reasonable level of pain from middle finger if I try and make a fist
Can't really grab on tight to anything with my right hand.

Any suggestions as to my next step?
Another physio? Surgeon?
The xrays showed nothing, although I thought that the operator was less than useless.

Need the hand for work.

[Zaynah]

:) hey. you could have torn some ligaments in the finger. there's lots of tiny ligaments at every joint in the finger, and with the trauma and strain you put on it, you could have torn them. A good thing to try and do, it to press on you middle finger, starting at the tip of you finger, pressing on every aspect of it and try to find a spot that is tender. if this is at a joint where your finger bend it might be a tear of the ligaments. Now, bend your middle finger slightly and try to keep it bent, and with your other hand try to push the finger straight (thus keeping the finger bent without movement against resistance). If you get that pain, it suggests you injured the tendon that runs on the palm side of the finger from your wrist over every joint to the tip of the finger. having done the above you should have an idea what you injured. you could go back to your doctor of physio with this and the best thing could be a MRI scan. it will detect any soft tissue injuries or abnormalities, but is expensive. i had one done after 8months of no diagnosis, and they found a huge cyst that they are going to remove in 4 weeks. Good luck:)

[6tee7]

Hi Zaynah,

Tried all of your suggestions and the pain seems to be initiated from the knuckle joint, midddle finger RH.

Any more suggestions? The joint appears to be slightly enlarged. If I grab the middle finger with my LH thumb under the knuckle joint and the LH index finger above the first joint and try to bend the finger down the pain is " high quality"

Do I go for an ulta sound or MRI?

Any suggestions for a good hand specialist in Melbourne?

[Zaynah]

hi

the knuckle joint where you say your pain is coming from, is called the 'metacarpal phalangeal joint" aka MCP joint.

if you take your other hand and pull you middle finger away from you index finger to the side so that you open up the area between the two fingers, does this hurt? This indicates injury at the collateral ligaments at the MCP joint at that side. Do it to the other side pulling it sideways away from the ring finger. Pain indicates instability or torn collateral ligament at the MJP joint on that side.

if it is tender and sore on the palm side of the knuckle, its an 'flexor' injury, so the tendons and ligaments involved in flexing (bending) the finger could be injured. if it is tender and sore on the backside of the hand at the knuckle, its and 'extensor' injury, so the tendons and ligaments involved in extending (straigtening) the finger at this joint could be injured. If it is sore in the little dip on the side of the middle fingers' knuckle, between your index and middle finger, it could be the 'collateral' ligaments, that stabilize the joint at the sides. the test where you try to keep the finger bent while trying to push it straight with the other hand tests the tendons as you are not moving the joint itself.

here is an article about hand & finger injuries:
http://www.aafp.org/afp/20060301/810.html
here is an interactive website on the different type of hand & finger injuries:
http://www.csuchico.edu/~sbarker/hand/hand.swf

if you read this, this might give you some insight into the injurie, proper diagnosis and treatment of it. If you look at the pics in this article you will see all the structures that originate or insert at this joint that could be a problem. it helps alot if you know about your possible diagnosis, how they should examine it, because then you know when a doctor is not doing his job properly.

Ultrasound can detect ligament and tendon strains, but could miss some too. It is the same with MRI! The best thing to do is to go to australia's orthopeadic surgeon website and look for a specialist there: http://www.aoa.org.au/surgeons.asp

Good luck:)