Fractured little finger and snapped tendon

[GypsieQueen]

Hi, I'm hoping that anyone with any knowledge of broken bones and/or tendons can help. A month ago I went out for drinks with a friend (well a friend of my sister's). We both got very drunk, her in particular. We were being very silly and she squeezed my hand very hard and crushed my little finger on my left hand. Ever since, it has been painful and swollen and bent. I stupidly convinced myself it was nothing serious and that in time it would get better. I'm a single mum of an extremely demanding two year old who has had one illness after another since starting nursery and all my focus has been on her. On top of this, I started a new job two months ago, after trying to get a job for months. It's fixed term for three months with the chance of becoming permanent. I didn't want to jeopordise my chances of becoming full term with taking time off and therefore didn't go to my GP. The average waiting time at my surgery is about a month anyway, so I thought it'd heal in that time. Anyhow, today, I was off work as my daughter is poorly. I took the opportunity to go to a Minor Injuries Unit and get it looked at, as the pain has been increasing. I had an x-ray which showed my bone is fractured and the tendon has split. I've been referred to a fracture clinic this Friday. The Nurse who saw me today said that he wasn't sure if anything could be done now, as I've left it so long. I'm really worried about how this will leave me. Will my finger always be bent and in pain? Will the bone have already started to heal, meaning it can't be straightened? Will it not be possible for the tendon to heal? It is so painful, I just am so worried I will be left like this permanently or whether I might need an operation which I will have to wait months for. Can anyone offer any advice? Please don't tell me how stupid I've been, as I know that. Thank you.

[JohnHunter]

Four weeks is enough time for the bone to have healed. If it has healed in a bent position then it would require an operation to re-break the bone and hold it straight to heal again.

The x-ray won't have shown a snapped tendon and so it's not really clear how they've determined this. If a tendon has been injured then it would also probably require an operation. This would be quite a bit trickier after a four week delay but still possible.

[Woodifer]

X Ray's can show tendon/ligament damage if they show where the little bit of bone where the tendon attached is pulled away/displaced. I cut the back of my little finger, and detached the bit of tendon that straightened the tip out. I could bend my finger down but not straighten it. I had a splint to hold my finger straight so the tendon could reattach. (Took about 6 weeks).

[Ceto]

When I broke a finger the X ray showed the snapped tendon. I didn't go to Minor Injuries until four days after the original accident: they put on a temporary splint and referred me to a specialist hand clinic who put on a fitted splint which I had to keep on for a couple of months with strict instructions to keep the finger straight when redoing the dressing. Then I was given physiotherapy exercises to do, and it's now fine. But sorry, I don't know what the position will be after four weeks.

[JohnHunter]

Ahhh... you have a mallet finger? Is it just the tip that's bent downwards and they've now put you in a little splint like Ceto is describing? If so, please ignore my earlier post as this is quite different to what I'd envisioned from the description.

The long-term outcome will depend a bit on whether you've truly snapped the tendon or pulled it off the bone. I've seen people get reasonable results after delayed application of a splint for a tendon injury ("soft tissue mallet finger"). It's likely that you would be left with a slight bend but hopefully a lot less than is there now.

If it has pulled a flake of bone off the finger ("bony mallet") then it might be difficult to improve things in a splint at this stage because it will presumably have healed in the wrong position. They will probably try the splint anyway in the hope of achieving some improvement.

Hopefully you'll get some proper answers at your clinic appointment tomorrow.

[GypsieQueen]

Thank you all for your replies. I was told that I had a mallet finger and that a bit of bone had broken off and the tendon had snapped. I'm hoping there is something that can be done and that I won't be sent away with it left as it is, with no splint or anything, as it's really uncomfortable and painful. If I do need an operation, I presume it would be a very long wait.

[JohnHunter]

Okay... a bony mallet makes sense. They probably meant that the tendon has pulled off and taken a small piece of bone with it. If this is the case, the tendon itself is intact but not detached from the end of the finger.

Is your finger in a mallet splint now? Either way they will likely give you a splint tomorrow and trial that for around 6 weeks to see whether the droop can be corrected. It won't correct 100% but might be enough.

If that's not successful then they might offer an operation but you are right in that there might be a wait (possibly months) for this. You won't necessarily be in pain for that time - once the bone has healed (albeit in the wrong position) it might be bent but shouldn't really hurt.

[JohnHunter]

("now detached" instead of "not detached")

[GypsieQueen]

Just an update. I've been given a mallet splint which I need to wear for 4 weeks when I will have another appt at the fracture clinic. I've been told it's unlikely to work and most likely I will need an operation. It is not going to ever be the same again though I have been told.