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Possible avulsion fracture at DIP joint - advice sought (Read 2565 times)

petejh

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I was crimping (very) hard on a fingery problem yesterday, and last night woke up with severe pain in the DIP joint (joint closest to fingernail) of my middle finger - sharp pain like a fracture. I now can't flex that finger beyond a couple of degrees. The DIP joint is swollen but there isn't any bruising as far as I can tell.
I've been for an x-ray and I'm awaiting the radiologist report at the end of the week - the nurse looked at the x-ray and she thinks I have an avulsion fracture at the DIP joint, but the doctor said he's not convinced. All I know is it fucking hurts to move it at all and I want it sorted asap. It's been buddy splinted.
 
Does anyone have experience with a DIP joint avulsion fracture or flexor tendon sprain/rupture? And can anyone recommended a good specialist in case I need to see one?

Kingy

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Hi Pete
Yes I got an avulsion fracture of my right ring fingerend joint in Ceuse 3 years ago when I hyperextended it while dynoing from a pocket, I basically dynoed and left the finger behind, ouch!

It swelled up and I thought it was just bruising so rested 2 days and then sent an 8a on it but could tell it was not right. I went to the Xray dept and the xray confirmed that there was a little chunk of bone ripped away from the main bone. This is apparently when the tendon parts company with the bone it literally rips a chunk of bone away with it, gnarly!!

I saw a few specialists who were helpful and I splinted the finger for a few weeks which helped the healing process I think. I ended up taking 6 weeks rest off in total then started back with really easy climbing. Within 2 months I was back to sending 8a+ again.

The finger is still a bit enlarged bizarelly on the opposite side of the injury site as it seems that the initial swelling fluids seep through the finger joint and out the other side as the body' natural reaction to the trauma. Unfortunately this has not gone done ever despite attempts to mass age it away. I am now resigned to not being able to use the ring finger mono on Make it Funky at the Tor!

I hope this helps and good luck with your rehab if you need it.
Ted

petejh

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Thanks Ted. What was your experience with splinting - did you have it immobilised 24/7 for those few weeks, or just at night? I'm already beginning to wonder how much mobility might be lost!

I think I'll be looking for a specialist then.

Never fractured anything before, amazingly, but this feels like how I'd imagine a small fracture to feel - properly jarring pain if I accidentally knock it against something. Weird how it came on during the night instead of while I was using it, though it didn't feel quite right at the time, a bit stiff/swollen.


Kingy

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Yes I think you will know deep down if there is something wrong with or not. Regarding splinting IIRC it was just at night. It felt like it helped a bit to immobilise the joint a bit while it healed but probably just something that is automatically done in all hand trauma cases as a matter of course. I think not splinting during the day will keep it mobile and avoid it seizing up, although my medical knowledge is rather limited in this area TBH! Soons heals up with a bit of rest

petejh

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Just a bit of follow-up on this for anyone who does anything similar, because I couldn't find much info out there for DIP joint injuries that aren't full-blown avulsions requiring surgery -

I buddy taped the finger for 10 days. I couldn't flex it at all with the splint off - or at least trying to would produce a jolt of pain in the underside of the DIP.
I was worried about the FDP tendon after reading horror stories on the web  ::)  so I booked to see a specialist about a week after first injuring it. Saw him, and he booked me an MRI, thinking that it might be an FDP tendon partial rupture. I got the MRI last week and it didn't show anything wrong - the radiologist (who the hand specialist recommended as he often uses him for his clients) said he could see no reason for further symptoms.
The finger's improving and 3.5 weeks after injuring it I can now flex it to the palm without pain, just a lot of stiffness. It's still quite badly swollen from the DIP down to the PIP. No tenderness in the pulleys or collateral ligaments. The DIP joint seems to 'catch' and lock every now and again, then I'll give it a shake and it'll release with a little click. Definitely feels like something's locking up in the joint like a splinter of bone or a lump of something
Did 50 mins of really easy top-roping yesterday without any pain. That made it swell up some more the next day.
I still don't know exactly what I did to it. Basically I think I just hyper-extended and overstressed the DIP, but not enough to fracture it or tear the tendon.

 

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