Finger Injury: Types, First Aid and When to See a Doctor

First aid for an injured finger

1. Remove rings right away, before swelling makes this impossible.
2. Ice: apply an ice pack wrapped in a cloth for 15 to 20 minutes every 2 to 3 hours for the first 48 hours.
3. Raise the hand above heart level.
4. Protect: buddy tape the injured finger to its neighbor, or use a splint, only if it moves normally and looks straight.
5. Pain relief: acetaminophen (paracetamol) or ibuprofen, following the label dose.
6. Do not pull on a dislocated or crooked finger to "pop it back"; get it checked.

Types of finger injury

Jammed finger

A jammed finger happens when a ball or object strikes the fingertip and compresses the joint, usually the middle (PIP) joint. The joint swells, aches and feels stiff. If you can fully straighten and bend it, and it is not crooked, it is likely a sprain. Buddy tape for 1 to 3 weeks and move it gently as pain allows. A middle joint can stay slightly swollen for several months.

Tendon injuries that look like sprains

These are often missed and are the main reason to check your movement carefully:

• Mallet finger: the tip droops after a ball hits it. It needs a splint that keeps the tip straight, worn continuously for 6 to 8 weeks. Even one bend during that time can undo healing.
• Jersey finger: the fingertip cannot bend after the finger is yanked, for example grabbing a jersey. It usually needs surgery within 1 to 2 weeks.
• Central slip injury: you cannot actively straighten the middle joint. Without splinting, a boutonniere deformity develops (middle joint bent, tip bent back).

Skier's thumb

A fall with the thumb pulled outward, often holding a ski pole, tears the ulnar collateral ligament. Pinching and gripping become weak and painful. Partial tears are treated in a thumb splint for about 4 to 6 weeks. Complete tears often need surgery.

Nail and fingertip injuries

A painful, throbbing blood blister under the nail (subungual hematoma) can be relieved by a clinician making a small hole in the nail. A torn nail bed, or a crushed fingertip with a fracture, is repaired to help the nail regrow smoothly.

Is my finger broken or jammed?

You cannot always tell without an X-ray. Signs that point toward a fracture or dislocation:

• the finger looks bent, shortened or rotated (when you make a fist, the fingers should point toward the same spot at the base of the thumb; one crossing over another suggests a rotated fracture)
• severe swelling and bruising spreading along the finger
• pain directly over the bone rather than only at the joint
• a joint you cannot move at all
• a grinding or clicking feeling

How doctors diagnose finger injuries

The clinician checks each joint's movement, stability and alignment, tests feeling on both sides of the fingertip, and looks for nerve, tendon or blood vessel damage. X-rays in two or three views show fractures and dislocations. Ultrasound or MRI is occasionally used for tendon and ligament tears.

Treatment

• Buddy taping: for sprains and some stable fractures, for 2 to 4 weeks.
• Splints: for mallet finger, central slip injuries and many fractures.
• Reduction: realigning a dislocated joint or displaced fracture under a numbing injection (digital block).
• Surgery: for unstable or rotated fractures, fractures into a joint, jersey finger, complete thumb ligament tears and cut tendons or nerves.
• Wound care: cleaning, stitches, tetanus booster and antibiotics for open fractures and bites.
• Hand therapy: exercises and splints to recover movement. Fingers stiffen quickly, so early movement of uninjured joints matters.

Recovery

Most sprains heal in 1 to 3 weeks. Finger fractures usually unite in 3 to 6 weeks, but full strength and movement can take 2 to 3 months, and some swelling of a joint may persist for 6 to 12 months. Return to sports often allows buddy taping or a protective splint. Larger hand injuries are covered under hand injury.

Frequently asked questions

How do I know if my finger injury is serious?

Get it checked if the finger looks crooked or rotated, cannot fully straighten or bend at any joint, has severe swelling or bruising, is numb, has a deep cut, or the pain is not improving within a few days. A tip that droops or will not bend is a tendon injury that needs prompt treatment.

How long does a jammed finger take to heal?

A mild jammed finger usually feels better in 1 to 3 weeks with ice, elevation and buddy taping. The joint may stay slightly swollen and stiff for several months, especially the middle joint. If it does not move fully after a week or two, have it examined.

Should I buddy tape a jammed finger?

Yes, if the finger is straight and moves fully. Tape it to the neighboring finger with a small pad between them, leaving the joints free to bend. Do not buddy tape a finger that is crooked, cannot be straightened, or may be broken until a clinician has checked it.

Why can't I straighten my finger after an injury?

Inability to straighten the tip usually means mallet finger, a torn extensor tendon. Inability to straighten the middle joint can mean a central slip injury. Both need splinting, often for 6 weeks or more. A dislocation or fracture can also block straightening.

Can a broken finger heal on its own?

Some stable, well-aligned finger fractures heal with buddy taping or a splint alone. Fractures that are rotated, displaced, or extend into a joint can heal in the wrong position and leave a crooked, stiff finger. An X-ray shows which type you have.