Question:I ruptured a tendon in my ring finger at work last year. I've had nothing but trouble ever since. Surgery to repair the tendon didn't work. The finger is permanently stuck in a bent position. It catches on everything. I think my hand would work better if they just cut it off. Is this ever done?
Answer:Amputation for disabling flexion contractures has been suggested. A flexion contracture is the name of the deformity that occurs when the joint can't straighten out fully. When the middle joint of the finger is flexed, grasping large objects, putting on gloves, or even shaking hands becomes an impossible task.
It's not likely that a hand surgeon would amputate your finger without a fair trial of therapy or conservative care first. A hand therapist will teach you how to do exercises to get the nerves and tendons gliding smoothly.
Passive and active range of motion exercises might help, too. If there are adhesions or scar tissue holding the joint in place, the therapist can try using deep heat and manual therapy to release the soft tissues.
Splinting and even serial casting might be used over a period of weeks to months. If after at least six months of active therapy (with your cooperation) you have not gained motion, then a fusion or even amputation may be considered.
If there are no problems with circulation or blood loss to the area, fusion may be the best first step. If fusing the joint in an extended position doesn't alleviate your problem, then amputation is the last step considered.Christopher J. Hogan, MD, and James A. Nunley, MD. Posttraumatic Proximal Interphalangeal Joint Flexion Contractures. In Journal of the American Academy of Orthopaedic Surgeons. September 2006. Vol. 14. No. 9. Pp. 524-533.
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