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avulsion fracture in finger
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el_capitan


May 28, 2007, 12:03 PM
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avulsion fracture in finger
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Let me say, first off I am stubborn. I won't go to the doctor unless absolutely necessary and I think I can toughen it out. About 3 years ago, the middle knuckle (PIP joint?) on my right middle finger was pretty sore after a night of gym climbing. I don't remember "popping" or any other acute injury. I just thought I would give it a rest, a week turned into 2-3 months and I went into see a doc. The finger looked crooked to me and very swollen. The doc confirmed that it was swollen (duh) but not that it was crooked. He said it was an illusion by the swelling and told me to just rest. I climbed on an off of it for another year, finger still hurt saw another doc who told me after x-rays that I had an avulsion fracture. Went to ortho who told me that I had two options: exploratory surgery with no guaranteed results or a cortison shot. I took the shot. Nothing. Now another year later I went to see another doc, who is referring me to ortho again. This time I made sure to request a different doc, but you know how HMO's work. I have to wait 2 months for my appointment.

so in the past 3 years, I went to see numerous doctors, taken 2-3 months off from climbing at a time, only to be not healed so I just get back climbing and deal with the pain with ice ( or an icy beer in my hand also helps) and climb at a lower grade and avoid right finger pockets.

My symptoms, 24-7 swelling in my right middle finger at the second knuckle, loss of range of motion, can't straighten all the way and when I do try to straighten it out with the help of my other hand, exreme pain (on the bottom of my finger), can't squeeze all the way either (pain on top), looks slighly crooked, and feels like scar tissue has built up inside. As far as strength goes though, as long as I can tolerate the pain its pretty strong. Obvisouly crimpers and pockets hurt the most.

I'm finally seeing another ortho in a few weeks. A friend suggested skipping the ortho and going to a hand specialist even though I might need to pay out of pocket. Any experiences out there with exploratory finger surgery? Any help would be greatly appreciated.


moose_droppings


May 28, 2007, 12:42 PM
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Re: [el_capitan] avulsion fracture in finger [In reply to]
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An avulsion is a tear (flap) of the skin. I've never heard of an avulsion fracture (fracture implies bone). A cortizone shot would help with the joint pain (tendons, cartilage) and is basically a steriod shot. Don't rely on these to often.

Hopefully its not a torn tendon in the joint, as you would need to quit using it completely for quite a spell. If its torn cartilage, the piece may need to be removed.

Good luck and let me know what you find out.


el_capitan


May 28, 2007, 12:48 PM
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Re: [moose_droppings] avulsion fracture in finger [In reply to]
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Yes it is an avulsion fracture. They showed me the x-ray of a little piece of bone that broke off. However the ortho didn't think it was necessary to go in and remove it. Just gave me the shot.


mince


May 28, 2007, 1:01 PM
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Re: [el_capitan] avulsion fracture in finger [In reply to]
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I got an avulsion fracture on my ankle, my options were take the piece out or pin it back the bone. I did neither and with enough training i am back to normal again.


el_capitan


May 28, 2007, 5:05 PM
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Re: [mince] avulsion fracture in finger [In reply to]
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Mince,
can you give me more detail about your injury. What were your symptoms: swelling, range of motion, pain, etc. And what do you exactly mean by training and by "normal". What was your time frame?


mince


May 28, 2007, 5:48 PM
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Re: [el_capitan] avulsion fracture in finger [In reply to]
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Doing a highball this winter I fell about 25 feet and rolled my ankle over. This caused the tendons connecting my foot to my leg to pull off a piece of bone, from the Fibula. I waited a day, and was in a lot of pain, then got it x-rayed and found out about the break. For about two weeks i was on crutches, which is not easy in the middle of the winter in Gunnison. My foot was so huge i couldn't fit it in my sorels with or without a brace on it. I was on my feet again after two weeks, but almost always in a brace. I got a balance board from fitter first exercise supply to help rebuild the stabilizer muscles in my ankle. I also iced it every night for about a month and a half and started taking some Chinese herbal joint medication which helped for me. I stayed on mostly steep climbs to keep the pressure off of my feet. After about two months it started to get back to normal size. I did decline having a surgery, but i think i am better off for it now. I also started slacking alot which helps. So i am back to about 99% now from an injury that happened in February. Oh, and i am not a doctor of western medicine, and this was not health advise just the facts of my case. Make your own decision, and good luck


(This post was edited by mince on May 28, 2007, 5:53 PM)


gunkjunkie


May 28, 2007, 5:50 PM
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Re: [el_capitan] avulsion fracture in finger [In reply to]
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Hi -

This sounds familiarFrown. Several years ago I had a similar problem - couldn't climb, type of tie my shoes. The hand doc finally said I tore a bit of the ligament away and a fragment of bone with it. The hand doc tried, unsuccessfully, to treat the inflammation with a cortisone injection.

What helped me was rest, accupuncture for the inflammation and stretching exercises for the tendons which were becoming thickened. Unfortunately, the finger is not as strong as it was, there is some calcium build up around the site where I guess the injury was and it is often a bit sore. I tape it when climbing and have modified the way I use holds so as to avoid further damage.

I definitely recommend trying accupuncture.

Edited to add: I forgot - I also used moxa to help warm up the hand before stretching and for pain relief at times. Chinese medicine - you burn a small amount of it near the area - for deep reaching heat. Only drawback is that you will smell like the inside of a hash pipe. Tongue
Deirdre


(This post was edited by gunkjunkie on May 28, 2007, 5:53 PM)


reno


May 29, 2007, 4:25 AM
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Re: [moose_droppings] avulsion fracture in finger [In reply to]
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moose_droppings wrote:
An avulsion is a tear (flap) of the skin. I've never heard of an avulsion fracture (fracture implies bone).
http://orthopedics.about.com/...bones/a/avulsion.htm


el_capitan


May 29, 2007, 7:43 AM
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Re: [gunkjunkie] avulsion fracture in finger [In reply to]
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gunkjunkie,
your symptoms sound similar to mine. However I didn't tear the tendon or ligament off but just broke a piece of bone off. Perhaps I did tear it off and it healed on its own since I waited so long to see the doc. I am having similar symptoms as you though. I also have hardening around the knuckle which I assume is calcium deposits like you mentioned.

What do you mean by stretching? What I have been doing is using my good hand to help straighten out my finger which I can't straighten out all the way on its own. I use gentle pressure and stretch till there is moderate pain. I don't know if I am doing more harm by doing this or if this is "stretching" and good for the finger. Ice after climbing always feels good and I tape it also. It seems like if I don't move it for a while, it becomes stiff = in the morning after climbing is the worst. Warm showers seem to help loosen it up too.

I think I'll try acupuncture and try moxa. Where do you get moxa? You said it was chinese medicine so do you get it at an asian grocery store?


(This post was edited by el_capitan on May 29, 2007, 7:44 AM)


moose_droppings


May 29, 2007, 8:14 AM
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Re: [reno] avulsion fracture in finger [In reply to]
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reno wrote:
moose_droppings wrote:
An avulsion is a tear (flap) of the skin. I've never heard of an avulsion fracture (fracture implies bone).
http://orthopedics.about.com/...bones/a/avulsion.htm

Thanks for the link.
Learned something new. We've never touched on this so far in my training.


(This post was edited by moose_droppings on May 29, 2007, 8:14 AM)


reno


May 29, 2007, 8:19 AM
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Re: [moose_droppings] avulsion fracture in finger [In reply to]
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moose_droppings wrote:
Thanks for the link.
Learned something new. We've never touched on this so far in my training.

No problem. Glad to help.

BTW, what training?


moose_droppings


May 29, 2007, 8:25 AM
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Re: [reno] avulsion fracture in finger [In reply to]
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I've been an EMT-B, but I'm in the process right now to upgrade that to an I.


reno


May 29, 2007, 4:49 PM
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Re: [moose_droppings] avulsion fracture in finger [In reply to]
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moose_droppings wrote:
I've been an EMT-B, but I'm in the process right now to upgrade that to an I.

OK, cool. Yeah, the EMT-B curriculum doesn't get into much detail about specific types of injuries, nor does the EMT-I.

Nor, sadly, does the EMT-P. Ortho is one of those things you'll have to learn on your own.

BTW, if I can be of any help during your training, feel free to holler.


(This post was edited by reno on May 29, 2007, 4:50 PM)


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