Why is my middle finger curved towards the ring finger?

Question

Hi doctor,

Yesterday, I noticed that my left-hand fingers look different which is some sort of out of place. The left ring finger is no longer straight and is leaning towards my index finger. I am not sure if the other fingers look normal or not. But, it is annoying me. The ring finger is bent, leaning on my middle finger like they are stuck together and it feels weird. There is less movement of the fingers. I have no idea what has caused this, but it definitely started yesterday and I did not injure myself. It makes no sense, but is annoying me. What is it? Can I get rid of it? Please look at the pictures I have attached.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your history as well as the images attached to the query (attachment removed to protect patient identity). This is the subluxation of the metacarpophalangeal joint (MCP joint) towards the radial direction. To determine subluxation towards the palmar side or dorsal side (back of the hand), one X-ray is required. The reason for such a spontaneous dislocation or subluxation can be a spontaneous radial subluxation of the extensor tendon or late changes in rheumatoid arthritis or trauma. Both of these are less likely as there would have been a clear history of such events. This could very well be a spontaneous volar subluxation of the MCP joint, but an X-ray is required to confirm the same. My recommendation is to visit your local orthopedic surgeon or post the X-ray of your hand if available so that further discussion is possible according to the etiology. Also, mention whether the joint is supple or not and whether all the movements are possible like that on the other hand. Is there any difference?

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have mentioned already that the two causes are,

Spontaneous volar subluxation of the MCP joint.
Spontaneous radial subluxation of the extensor tendon.

X-ray of the hand does not take time as it is essential to understand the pathology. Secondly, you have not mentioned whether you can correct the deformity by actively moving the finger or whether it can be completely corrected by passive force using the opposite hand? The nature of the deformity whether fixed or supple is a very basic examination detail required in such cases. During the initial stages, when the joint is mobile the condition can be easily managed by splints and minimal surgical procedures with near normal function with good cosmetic results. Once the condition progress and the deformity become fixed, then it can be corrected by various surgical procedures, and the morbidity increase in such cases. As your other fingers appear normal, it will not resolve on its own and some form of intervention is required by the doctor. There are high chances of progression of the condition with lack of treatment.

Thank you.