Episode Transcript
Dr. Miller: You jammed your finger? Is that just it or is it something else that you ought to worry about? We're going to talk about that next on Scope Radio.
I'm Dr. Tom Miller and I'm here with Nikolas Kazmers, and he's a specialist in hand surgery and orthopedic surgeon here at the University of Utah, in the Department of Orthopedics. Nik, a lot of times we get jammed fingers and we stub them on stuff, or we play sports and we smack the ends of them, and then the joints swell up in the fingers. Most of the time, maybe we don't think about that as we should. What's the downside of not coming in to be seen for a jammed finger?
Nikolas: More often than not, when somebody jams their finger, that swells and it's painful, usually it's just that, just a jammed finger.
Dr. Miller: Usually.
Nikolas: Usually. Occasionally, it can represent a more significant injury, such as a fracture, or broken bone, or dislocation, basically where the joint comes apart. And that warrants further treatment.
Dr. Miller: Maybe there's really no way to know that.
Nikolas: That's right. Early on, the finger hurts, it's swollen, you don't want to move it. Whether it's something like just a jammed finger, whether there's no more significant damage than just that. But you're exactly right. If there's a more serious injury, oftentimes that looks exactly the same for the first few days or even first few weeks.
Dr. Miller: So should everyone with a jammed finger be seen by a physician and have an X-ray, or is there a way to tell whether your jammed finger might be worse, to the point that it ought to be evaluated for a fracture dislocation. How do we do that?
Nikolas: Good question. I don't believe every jammed figure needs to come in for evaluation, but any patient that's concerned should seek further evaluation. It's relatively easy to get an X-ray to make sure that there's no more serious underlying injury for that. Every patient knows their body and knows their pain tolerance more than any physician out there does. So I think that can be an important guide. If things seem abnormal, aren't working normally for you, it's definitely worth coming in for a quick evaluation.
Dr: Miller: How about duration? If it goes on beyond a certain number of days, would you advise that that be taken care of? I believe that if you wait too long, then you might have your irreparable damage and not being able to move that finger like it should be moved in the future.
Nikolas: That's true. I've had patients who have, unfortunately, not sought medical attention immediately, and they turn out to have a fracture or dislocation, say, eight weeks down the road. At that point, it's very difficult to treat. If this was something that we had seen a week or two after the injury, it would have some excellent treatment options. But down the road, we lose some of those options, and that can affect the outcome, meaning the patient is more likely to have a stiff finger, more likely to have pain, or if the fracture is within the joint surface itself, they might have a higher chance of getting arthritis down the road as well.
Dr. Miller: So let's say they come to see you or the patient is referred to by one of their family practice docs, you take an X-ray, you find out that there's a dislocation. What do you do, actually?
Nikolas: The first step would be to realign that or what we call reduce it, where you realign the joint. Depending on if there's a fracture or not or exactly which joint is involved, the treatments can vary somewhat. But there are certainly more treatments available if we catch this early than down the road. It's usually less invasive if we deal with these injuries early rather than late as well.
Dr. Miller: Now, this might be a crazy question, but what would be the most common ways people jam their fingers? Playing baseball, I think, might be one of them.
Nikolas: Yeah, baseball is a common one. Baseball or football. Sometimes just motor vehicle type of collisions.
Dr. Miller: So it sounds like the bottom line is if you have a jammed finger and it's sore after several days, you out to have it checked out, get an X-ray, and then make your way to a specialist on hand surgery, or someone who's very competent in dealing with these kinds of dislocation. If you don't do that, you could end up with arthritis and immobility and the finger is the worst, way too long.
Nikolas: I would definitely agree with that, and if it's just a jammed finger without any of these other more serious injuries, it would be great to meet with us anyhow, because these joints tend to get stiff even without a fracture, without a dislocation or more serious injury. And we can have you meet with a certified hand therapist to work on a therapy program, splinting, we can work on pain control measures, swelling control measures. So, even if there is not a more significant injury, we still can help these patients.
updated: March 24, 2021
originally published: January 31, 2017