Torn volar plate one year ago, recently complicated


Q: I tore the volar plate in my pinky over a year ago. I was in physical therapy for a month or so and they told me we didn't need to go anymore. Then a couple weeks ago the middle joint popped and hurt really really bad. Now there is a hard and swollen bump on top of the middle joint. The pain seems to be getting worse. It has gotten to the point I can't even do the exercises I'm supposed to do to help it. Why didn't my hand heal in four months like it should have? What can I do to help my hand heal?


A:     I strongly recommend you that a Hand surgeon re evaluate your case, because he treatment of finger injuries can be complex and controversial, with more than one treatment option for most injuries, the treatment must be individualized  according to the age, sex, configuration and composition of defect if there is any, digit injured, hand dominance, pre-existing medical conditions, occupation, hobbies, and mechanism of injury, as you can see there are several factors influencing the healing process. Generally, the finger wound should be assessed for tissue loss. If there is minimal tissue loss then the wound can be debrided and closed primarily. If the wound can’t be repaired this way and no bone is exposed,  the wound measures less than 1 cm, consider open treatment or skin grafting. If the wound is larger than 1 cm, skin grafting would provide quicker wound healing.

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