Jammed finger injuries range from simple jams to dislocation, fractures

By Michael Dolan, M.D.

One of the most common basketball or volleyball hand injuries is a jammed finger. This injury occurs from a blunt impact or forced motion to the proximal interphalangeal joint (PIP) of the fingers.

Fingers are comprised of three different joints. Each joint is supported by ligaments, called collateral ligaments. On the palm aspect of the joint is a structure called the volar plate. A jammed finger is generally a sprain or injury to one of these ligaments.

Depending on the severity of the impact, which will stress the ligaments at your PIP, the varying degrees of this injury will range from a simple jam to a more serious finger fracture or dislocation.

As with all sprains, the severity of the injury can vary. First degree sprains are mild, involving a stretch but no tear of a ligament. A second degree sprain is a partial but not complete tear of a ligament. And a third degree sprain is a complete rupture of the ligament. In such cases of complete ligament ruptures, the finger generally becomes dislocated.

Symptoms of a jam to the PIP include swelling, loss of range of motion, pain and tenderness to touch. With first- time dislocations, it is not uncommon for a small piece of bone to be torn off along with the ligament. This type of fracture is called an avulsion fracture.

Treatment Options

If you are like many athletes, one of the most common recommendations for an acute finger sprain is to “pull it out.” This should not be done. Pulling on any joint could create further stress on a newly injured ligament.

If you have any deformity or if you suspect that the finger is dislocated, get an X-ray of the finger to determine if there is a fracture or an avulsion fracture.

In most cases, RICE therapy is recommended, which involves the following steps:

• Resting the injured finger/hand.
• Icing the finger 15 minutes every hour for the first 48 hours. (After 48 hours, switch over from ice to heat.)
• Compressing the finger with a splint to keep it from bending.
• Elevating the finger above chest level.

During the early stages of healing, limiting motion is necessary to reduce ligament stress. To help protect the joint, the easiest means is to use buddy taping. This is done by simply taping the finger to the next finger to help splint and support it.

If symptoms persist or worsen, or if full mobility does not return in a matter of days, be sure to see an orthopedic surgeon. Your physician will likely take X-rays to rule out a finger fracture, and may prescribe anti-inflammatory medications to help reduce swelling.

Your physician also may prescribe a customized stretching and strengthening program during the rehabilitation stage. Formal therapy may be required in more severe cases.