After a fracture, my finger looks bent and swollen. Should I go for a surgery?

Question

Hello doctor,

I broke the top joint of my right pinky finger, two and a half months ago, late the night, before I was leaving for a two-month trip abroad. I tried to splint it, but it did not work, and it bent down by about 45 degrees, and now the joint is swollen. After getting an X-ray, now that I am home, the specialist said that I could try to splint it religiously for six weeks, to see if it works, with results of a 10-degree bend and a slight bump. He said it has a 50 % chance of working given the time-lapse. If it does not work, I will need surgery, where he will clean up the extruded bone, and put something between the joints, and a pin, that will need to be removed. I will wear a splint for six weeks and need some physiotherapy. The other option is just to have surgery now, and avoid the six-week test. It seems like the surgery now might be the better option to provide a better long-term solution, versus the results of the splint if it were to work. What do you suggest?

Answer 1

Hello,

Welcome to icliniq.com.

Two and a half months is a very long time for a phalanx fracture to heal. There is no role of splint after two months. So, I would not recommend wearing the splint for six weeks on a trial basis. To decide whether there will be any movement at the joint or not, I need to see the current condition of the joint, to determine the congruity of the articular surface. If the joint is congruent, then physiotherapy or physical mobilization will bring a range of motion. If it is not congruent, then surgery is required. Swelling in the region of fracture is very normal, due to increased blood supply to facilitate fracture healing. Kindly follow up with your X-ray for further discussion.