Why Your Jammed Finger May Be a Much More Serious Injury

Dec 12 / Build Muscle

The day after I jammed my middle finger catching a football, it remained bent and had swollen to twice its size. I was a little concerned, but blew it off, figuring that it was just a bad jam. I’d had them before.

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Five days later, though, my finger had turned bright green and purple, and wouldn’t straighten on its own. I quickly made an appointment with an orthopaedic specialist.

Turns out, it wasn’t a jammed finger. It was an “acute boutonniere deformity.” The injury occurs when there is a forceful blow—like a fast-flying football, a hard chest pass during a basketball game, or a slide into first base—to the tip of your finger while it’s straight.

The tendon that runs along the top of your finger—called the central slip—tears, and the joint’s middle knuckle pops through, explains Dr. Michelle Carlson, M.D., a hand surgeon who specializes in sports-related injuries at the Hospital for Special Surgery in New York, New York. (Want to keep other body parts safe while working out? Here are musclemorphosis.com.)

Another way to envision it: Boutonniere means “buttonhole” in French. Think of your torn tendon as the “hole,” and your joint as the “button” that slides through. This tendon is responsible for extending your finger, which is why you can’t keep it straight once it tears.

And since the injury usually happens during sports, it initially can be difficult for the average person to tell the difference between a boutonniere deformity and a jammed finger, which is a sprain to the covering of the knuckle, says Dr. Carlson.

“It may seem like your finger is OK. You may even be able to move it a bit,” she says. “But just being able to move your finger doesn’t mean you don’t have a fracture or a tendon injury.”

If you see a doctor right away, you can treat a boutonniere deformity with a splint most of the time, according to Dr. Carlson. Your doctor will also X-ray your hand to make sure there isn’t a fracture to the middle joint, too (which is what happened to me).

But if you wait too long to seek help, your central slip can tear all the way, sliding down toward the palm side of your hand. If that happens, you may need surgery, she says.

“It’s always easier to treat it right away than weeks down the line.”

And if you never seek help? You risk permanent deformity, and your finger could be rendered useless, she says.

Dr. Carlson says she also treats a lot of patients with mallet fingers. It’s a much more common injury to the same extensor tendon, but it occurs at the top joint instead of the middle joint. The tip of your finger usually droops down.

“Sometimes when this happens, it’s not even that painful,” she says. “It can also happen during sports or when you take a fall, but I’ve seen patients who have done it just making their bed or even pulling up their socks. They catch their finger and it can happen. The tendon pops off the tip.”

Dr. Carlson recommends getting to a doctor sooner rather than later because it can usually be healed with splinting.

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As for me, I wore a splint and attended physical therapy for 8 weeks. I finally have full range of motion back in my finger’s middle joint, although it still hurts to bend all the way. But, hey, that’s better than living with a jacked up looking finger.

And if you still aren’t convinced that you should see a doctor for that “jammed finger,” just go ahead and Google image boutonniere deformity. If I can’t persuade you, those pictures should. (Now that you've figured out how to heal your finger, here are musclemorphosis.com.)