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Suggest treatment for fracture in finger

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Posted on Mon, 7 Dec 2015
Question: I went to the ER this past Thursday night after I cut my finger badly on my bandsaw, while woodworking. They told me I severed my extensor tendon on my dominant (right) hand pinky finger. They also said it was dislocated and someone said something about a fracture. They irrigated the wound, administered iv antibiotics, put 4 big stitches in the cut, and wrapped the finger and my wrist with my finger in its retracted and dislocated position. I was given a referral to a local orthopedics specialist to see in the morning (Friday) and a two days supply of oxycodone (12, 5mg tablets). Is that a typical treatment that I received that night? Was that a typical level of oxycodone for an injury like this? It is not effectively keeping my pain at bay but would feel odd asking for more. I am a healthy 25 male weighing 175 and taking 70mg of vyvanse daily AM, escitalopram 20mg/daily AM, and up to 2.5mg lorazepam as needed. I have no allergies or react poorly to any medicines I've been given.

The next morning I was at the office the ER reffered me to. They unwrapped the wound, cleaned it, pulled my finger straight to get the joint closer to where it should be and away from where it may cause pressure on surrounding tendons/joints in the dislocated position. They wrapped my hand with my finger in a splint and scheduled me for surgery on Monday morning. They said in surgery they would have to fix the severed tendon and relocate the bone. They may need to use 2 metal pins if joint can't be relocated securely. Is this normal to have a wide open wound with exposed tendons and not operate on it for 84hrs? How long would recovery be on something like this? How painful will this be/remain after surgery? What is a typical pain management regiment here? Is this a case where it will hurt a little for a day or two, or will it hurt bad for several weeks?
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Answered by Dr. Mukund Savaskar (3 hours later)
Brief Answer:
Right Pinky finger Fracture with cut Extensor Tenon/for Evaluation

Detailed Answer:
Brief Ans-Right Pinky finger Fracture with cut Extensor Tenon/for Evaluation

Hi,Dear,Thanks for the query to HCM.
I read your query and studied meticulously in all its details.I also reviewed this with your past medical history.

My Opinion-On your Various Queries-
Based on the facts, In My opinion,Your Er Doctors have given the best possible treatment at their hands.
The ER Doctors did gave you the best advise to refer You to the Local Ortho-Surgeon,who in turn has planned the right treatment in time with proper antibiotic cover.
Please co-operate with them and undergo the treatment of wire fixation of the broken bones and repair of the cut Extensor Tendon of the Right Pink finger.

In such a scenarios the questions about your worries, you asked could be replied as follows-

Q-i-Is this normal to have a wide open wound with exposed tendons and not operate on it for 84 hrs?

Ans-i- As your ER and Orthopedic Surgeon-doctors have covered you by antibiotic Cover,such wound could be managed by surgery after 84 hrs.
In a given situation like yours,this is the best that can happen to you.

Q-ii-How long would recovery be on something like this?

Ans-ii-Usually post-surgery-10 days would suffice to resolve the acute issues you may have.
Post-surgery K-wiring if done, would be kept for 3 weeks to 6 weeks,after which K-wires would be removed as the new bone strength would be Normal and could maintain the bone functions on its own.

Q-iii- How painful will this be/remain after surgery?

Ans-iii-Surgery would be mostly done under local-finger blocks with local anesthetics.
Pain there after-would be acute /but would be controlled under painkillers for 2 days by Intra-muscular/or Iv injections/ supported with oral painkillers with antibiotic cover for 5 days time.
After 2 days time the Oral painkillers would be sufficient to control the pain.
Rest Elevation during this 5-10 days time with splints for the finger and forearm to fix the movements of the wounded area.

Q-iv-What is a typical pain management regiment here?

Ans-iv-Typically the pain Management would be as told above.

Q-v-Is this a case where it will hurt a little for a day or two, or will it hurt bad for several weeks?

Ans-v-Yes,this will hurt a little for 5-10 days time,after which you can sustain the K-wires without painkillers.

Hope this reply would help you.
Keep Me updated by direct query to ME by my name.I would love to help you out if need be.

Welcome for any further query in this regard.
If you find this reply satifactory,Will appreciate You,to write excellent review feedback comments, to help the needy patients like you,at HCM.

Wishing fast recovery.
Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist.
M.S.Gen-CVTS



Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3606 Questions

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Suggest treatment for fracture in finger

Brief Answer: Right Pinky finger Fracture with cut Extensor Tenon/for Evaluation Detailed Answer: Brief Ans-Right Pinky finger Fracture with cut Extensor Tenon/for Evaluation Hi,Dear,Thanks for the query to HCM. I read your query and studied meticulously in all its details.I also reviewed this with your past medical history. My Opinion-On your Various Queries- Based on the facts, In My opinion,Your Er Doctors have given the best possible treatment at their hands. The ER Doctors did gave you the best advise to refer You to the Local Ortho-Surgeon,who in turn has planned the right treatment in time with proper antibiotic cover. Please co-operate with them and undergo the treatment of wire fixation of the broken bones and repair of the cut Extensor Tendon of the Right Pink finger. In such a scenarios the questions about your worries, you asked could be replied as follows- Q-i-Is this normal to have a wide open wound with exposed tendons and not operate on it for 84 hrs? Ans-i- As your ER and Orthopedic Surgeon-doctors have covered you by antibiotic Cover,such wound could be managed by surgery after 84 hrs. In a given situation like yours,this is the best that can happen to you. Q-ii-How long would recovery be on something like this? Ans-ii-Usually post-surgery-10 days would suffice to resolve the acute issues you may have. Post-surgery K-wiring if done, would be kept for 3 weeks to 6 weeks,after which K-wires would be removed as the new bone strength would be Normal and could maintain the bone functions on its own. Q-iii- How painful will this be/remain after surgery? Ans-iii-Surgery would be mostly done under local-finger blocks with local anesthetics. Pain there after-would be acute /but would be controlled under painkillers for 2 days by Intra-muscular/or Iv injections/ supported with oral painkillers with antibiotic cover for 5 days time. After 2 days time the Oral painkillers would be sufficient to control the pain. Rest Elevation during this 5-10 days time with splints for the finger and forearm to fix the movements of the wounded area. Q-iv-What is a typical pain management regiment here? Ans-iv-Typically the pain Management would be as told above. Q-v-Is this a case where it will hurt a little for a day or two, or will it hurt bad for several weeks? Ans-v-Yes,this will hurt a little for 5-10 days time,after which you can sustain the K-wires without painkillers. Hope this reply would help you. Keep Me updated by direct query to ME by my name.I would love to help you out if need be. Welcome for any further query in this regard. If you find this reply satifactory,Will appreciate You,to write excellent review feedback comments, to help the needy patients like you,at HCM. Wishing fast recovery. Good Day!! Dr.Savaskar M.N. XXXXXXX Surgical Specialist. M.S.Gen-CVTS