Finger laceration – numbness – muscular and nerve disorders forum – ehealthforum gas pain in shoulder

#

Unfortunately, you do not give enough information to be able to give you much specific feedback. Exactly where did you cut the finger? Do you have any deficits in sensation or movement? Unless you have cut a tendon or a digital nerve (at a point where it is big enough to repair), there is not much a hand surgeon can do. If the cut is distal to the last knuckle (the distal interphalangeal joint – DIPJ), the digital nerve has trifurcated, and cannot be repaired. But, in these cases, it is a short distance, so the nerve usually regenerates. Even if the cut is in a region where the nerve is big enough to sew back together, it is often done to prevent a neuroma, rather than to restore sensation. If sensation is regained, super, but usually it is never quite normal. And, since the finger can survive with one digital artery, the artery is very rarely repaired. (The nerve and artery usually run together in the neurovascular bundle.)

However, if the cut is on the palmar surface of the finger and you cannot bend one of the finger joints, then, a trip to the hand surgeon is necessary. Likewise, if it is on the top of the finger (dorsal surface) and you can’t straighten out the finger, you should see a hand surgeon.

It is not unusual to have some numbness right past the cut. This is due to the tiny branches of the nerve to the skin (the nerves branch out like tree branches). They usually regenerate. If you had cut the digital nerve, you would have complete numbness distal to the laceration (towards the tip of the finger). This would involve at least half of the finger (half way round), so when you touched the tip of the index finger to the thumb, you wouldn’t feel the index finger at all.

It is not unusual for the finger to be a little swollen and difficult to bend, due to the pain. The tendons that move the finger are on the palmar side (the two flexors tendons, FDS and FDP) and the dorsal side (back of the hand – the EDC). So, they would not be where the laceration was located.

Sounds like you lucked out. Keep the wound clean until it is healed (you can get it wet, just don’t soak it). Try to move the finger a little each day. Motion is very important to keep the finger from developing fibrosis and losing motion permanently (even if you have to use the other hand to help a little). You should regain function steadily.

From what you stated, you had a pretty good (or bad) laceration. You cut the neurovascular bundle completely and nicked a tendon. (Concerning the NV bundle, the good thing is you only need one artery, so if just one is cut, it is not repair. How do I know you cut the artery, because the artery and nerve run in the same tube. So to cut the nerve completely and reach the tendon, you had to get the artery also. But, again, it is no big deal.)

When the flexor tendon is just nicked, the little flap of tendon is resected, so the tendon is smoothed out. If you try to sew up a small cut, the suture actually gets caught in the pulleys. So, even a 50% laceration can just be smoothed out (the tendon is that strong). If the pulley is damaged, or has developed some scar tissue in it (which can occur in just a few days), then a pulleyplasty is performed (where it is repaired or just tidied up a bit).

So, yes, range of motion is very important for you to get your function back. If you can’t get through a full ROM yet, you can go as far as you can, then hold for a count of 10. Then straighten as far as you can, and hold. This is called "place and hold" of course. You should do this on the hour, for 6 to 8 reps. You can use your other hand to help with range of motion if needed.

I do hope you get sensation back in your finger soon. Playing when it is numb, will help you adjust, in case you don’t get quite full sensation back. Your finger has two digital nerves, one up each side. When one is not functioning like it should, the other side often grows some extra axons/dendrites (they are sort of like branches on a tree), to help cross the mid-line a little, to assist with sensation. With training, most people become fully functional, even if they don’t get "normal" sensation back. Again, hopefully, you will get back the sensation you need. But, it is going to take awhile.