John E. Blank, M.D., Hand Surgery, Tuckahoe OrthopaedicsBy John E. Blank, MD

If you’re experiencing an inability to straighten your finger(s), the cause is likely one of these four possible reasons. At the crux of determining which of these is causing the problem, it’s important to determine if it stems from a trauma-related injury or not.

Let’s take a look then at these four possible causes and spend some time investigating the more serious problems.

Jammed Finger

In the case of a jammed finger, swelling or bruising is likely to occur, especially as the injury is trauma related.

To alleviate the problem, I suggest following the R.I.C.E. method (Rest, Ice, Compression, Elevation), incorporating mainly the rest and ice to reduce swelling. Usually this is all that is required to mend a jammed finger. Some injuries are more serious and require the attention of a doctor.

If your finger happens to look particularly crooked or dislocated or is unbearably painful, see a doctor immediately. You may have broken your finger, which is a more serious problem.

Broken Finger

Broken fingers are most often revealed by the use of an x-ray machine and again, are associated with the occurrence of a traumatic event, whether it’s an injury while playing sports, falling, punching something, or possibly an accident.

Treatment of broken fingers depends on the type of fracture and the particular bone in the finger that is injured.

In the absence of a traumatic event, there are two other reasons you may not be able to straighten your finger.

Trigger Finger (Stenosing Tenosynovitis)

The first potential non-traumatic reason you can’t straighten your finger is stenosing tenosynovitis, commonly known as “trigger finger.”

Trigger finger involves the tendons and occurs when the fingers are not bending properly. In a healthy person’s finger, pulleys – like a series of rings — are meant to guide tendons through the tunnel.

When the first pulley becomes too thick, however, it is difficult for the tendon to pass beneath. The result is pulling and locking. If the tendon develops a knot, further inflammation and swelling takes place.

A person experiencing trigger finger may experience pain and/or a popping sound. It’s also possible for the finger to become locked in position.

The most important part of a trigger finger diagnosis is ruling out either an arthritic or traumatic issue. A cortisone steroid shot may be used to alleviate the issue, although no more than three should be given in any year. Should problems persist, surgery may be considered.

Dupuytren’s Contracture (Hand Deformity)

The final reason you might not be able to straighten your finger is known as Dupuytren’s contracture.

Dupuytren’s contracture involves the thickening of palmar fascia in the hand (tissue just beneath the palm).  This results in knots of tissue, eventually forming a thick cord that can pull one or more of your fingers into a bent position. A common complaint of someone suffering from the condition is that he can’t put his hand in his glove or pocket.

Dupuytren’s contracture is more common in men of northern European descent who are over the age of 40. For years, it has been thought to be a surgical disease (cords typically need to be divided or removed) but now many cases can be managed non-operatively with an enzyme injection. Because of the potential risk of recurrence, patients are commonly advised to wait until the contracture is significant enough to warrant surgery or injection therapy. Hand therapy and splinting are commonly utilized after treatment to maximize digital extension and functional outcome.

If you can’t straighten your finger and are concerned, I encourage you to make an appointment today.


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