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Fracture of proximal phalanx of ring finger - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3620 Questions
User :   Hello?
Doctor :   hi
Doctor :   how can i help u
Doctor :   please proceed with your query
User :   I have a problem with a broken finger. I am far away in India without access to specialist care
User :   i will tell you the details
User :   I had a bike accident
Doctor :   ok
User :   broke the proximal phalanx of the ringh finger
User :   i have x-rays i could send over if it is possible
Doctor :   ok
User :   how?
Doctor :   please send it to YYYY@YYYY
User :   ok, will you be able to look at it straight away?
Doctor :   do yu have the detailed reports of X- ray
User :   I don't think I got one
User :   I just have the images
Doctor :   ok
Doctor :   when did the accident happened
User :   yesterday
Doctor :   do yu still have swelling and pain
User :   the finger is in a full plaster cast now
Doctor :   ok
User :   i am afraid it needs to be set or manipulated in some way to heal prop[erly
User :   now the doctor just put the cast on without doing anything, and the finger is not even straight inside
User :   i sent the images
Doctor :   now its difficult to do any procedure
User :   there seems, to me, to be quite a gap between the broken pieces, and the whole finger points slightly sideways from the fracture and up
Doctor :   as the swelling and pain needs to be subsided
Doctor :   is the cast applied only for the finger or to the wrist also
User :   wrist also
Doctor :   ok
User :   how long does it take until the bone sets in what possibly is a bad way?
User :   I mean, how long do I have to change it
Doctor :   cast need to applied for atleast 2-3 weeks
Doctor :   if the fracture is well united and healed well
User :   yes, but i do not want to have a cast on if my finger is healing in a bad way inside
Doctor :   then there is no need for surgery
User :   did you get the x-rays?
Doctor :   it will take time for me reach
Doctor :   once i have seen it i will comment on it
User :   ok
User :   is it normal for there to be a gap of about 1,5 millimeters between the pieces?
Doctor :   the repeat X- ray will be done in another 10 days
User :   yes, that is all fine. I just do not trust the first diagnosis and treatment and do not want to wait until it is too late to fix it
Doctor :   ok
User :   I am anxious because I am a professional mucisian who needs full mobility of that finger
Doctor :   ok
Doctor :   do yu have any tingling or numbness in the fingers
User :   no
Doctor :   ok
User :   the cast is a bit loose, if you were thinking about that aspect
Doctor :   no i thinking about the nerve injury aspect
Doctor :   was the bleeding heavy
User :   the whole hand was quite bruised
User :   but no external bleeding
Doctor :   ok
Doctor :   its injury to more muscles and blood vessels
Doctor :   how is range of motion in the fingers
Doctor :   are yu able to move the fingers
User :   i can move all of them, but the broken one only a little in the top
Doctor :   ok
User :   I do not know if the doctor checked for rotation before the cast was put on. Later a friend told me it is very important, so now I am worried
Doctor :   you are right
Doctor :   if the range of motion is reduced or not possible
User :   so should I take it off and check and later have it recast?
Doctor :   the need of surgery becomes on more side
Doctor :   no need now
User :   I mean, it hurt to move the finger, and iit was really swollen, but there is mobility
User :   ok
User :   ah, you mean later?
Doctor :   ok thats a good news
Doctor :   on what medications are yu on
User :   antibiotics for a large cut under the cast... chephalexin
Doctor :   ok
User :   and paracetamol with anti-inflammatories
Doctor :   ok
Doctor :   has chymoral forte tablets added
User :   what is that?
Doctor :   these tablets reduces the swelling
User :   ok
Doctor :   and improve the blood circulation
Doctor :   so need to take Tab. Chymoral forte 2 times a day
Doctor :   after food for 3 days
User :   ok
Doctor :   even when cast is applied
User :   I am not typing myself, by the way, if you wondered about that
User :   ok
Doctor :   minor movements of flexion and extension movements are required
Doctor :   it should not be force ful
User :   I need to go quite soon. Any chance you can look at the x-rays when you get them and write me an email with what you think about the need for setting it better,appropriate cast and so on?
Doctor :   yes still 5 more min s
Doctor :   its downloading
Doctor :   almost done
User :   ok
User :   where are you. Also in India?
Doctor :   yes
User :   or can I not ask that kind of question
User :   just curious
User :   i guessed
Doctor :   you can
User :   I am in Leh
Doctor :   ok
User :   hard to get a second opinion here
Doctor :   Do not worry
Doctor :   when was the injury?
User :   yesterday at 11 in the morning
Doctor :   Is the swelling large enough ?
User :   i think it is going down now
User :   but it was very swollen
User :   bruised and cut also
User :   with the ring and middle finger the most swollen
User :   I was wearing a ring where the finger broke, I think that is maybe why it happened
User :   but the ring is naturally off now
Doctor :   ok
User :   getting the x-rays?
Doctor :   Yes i got them
User :   sorry to stress you but I was supposed to meet a friend 20 minutes ago
Doctor :   I think the strapping is done
Doctor :   now as per the treatment protocol
User :   the strapping?
Doctor :   Usually the strapping is done with the neighboring finger
Doctor :   it is called buddy strapping
User :   it is not strapped like that
Doctor :   and you are encouraged to move the fingers so that the tendons are not fixed
User :   ok
User :   so what, you say it should or could be buddystrapped
User :   and that it looks ok as it is, no need for setting or manipulation
User :   ?
User :   will the gap between the bits close?
User :   if it just heals like it sits now, will I have full mobility?
Doctor :   when were you asked to follow up?
User :   before I leave Leh, in 5 days
User :   then again after two weeks
Doctor :   Is it strapping or plaster of paris
Doctor :   Is it done with finger straight or flexed
User :   plaster, hard on bottom side, just padded and wrapped on the other
User :   in between
User :   not superstraight
User :   but more straight than flexed
Doctor :   were you asked to do the flexion movements
Doctor :   before the cast
User :   yes
Doctor :   I think this should go fine
Doctor :   The treatment differes if it is a displaced fracture
User :   it is not displaced?
Doctor :   This is not displaced
Doctor :   hence it should heal properly
Doctor :   Buddy strapping is done too
Doctor :   and asked to do active movements
User :   should be done, because it was not?
Doctor :   so that there is no fixing of tendons during healing
User :   the strapping
Doctor :   Ok
Doctor :   Once you leave leh,
Doctor :   you can see a specialist orthopedician
User :   will it not be too late then?
Doctor :   till then
Doctor :   this is fine
User :   ok. Thank you so much
Doctor :   Or you can see the same doctor and ask for the point
Doctor :   of Buddy strapping
Doctor :   Ok, Please fill the feedback form
Doctor :   Thanks for consulting us. Bye for now
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