Management of Jammed Sprained Finger in Primary Care
For a jammed sprained finger, immediate treatment should include rest, application of cold therapy for 20-30 minutes, and possible compression wrap for comfort, followed by functional rehabilitation exercises once pain allows. 1
Initial Assessment and Management
- A person with a painful finger injury that limits use should avoid activities that cause pain and seek medical attention 1
- Determine if the injury is truly a sprain or potentially a more serious condition such as a fracture, tendon injury, or joint dislocation 2
- Assess for signs of severe injury requiring referral, including:
- Obvious deformity
- Complete loss of motion
- Severe swelling or bruising
- Inability to bear any weight on the finger 1
Immediate Treatment
Cold Therapy
- Apply cold therapy (ice and water in a plastic bag wrapped in a damp cloth) to the injured finger for 20-30 minutes 1
- Cold application decreases hemorrhage, edema, pain, and disability 1
- Use a barrier between the cold container and skin to prevent cold injury 1
- Limit cold application to 20-30 minutes at a time, 3-4 times daily 1
Compression
- Consider applying a compression wrap for comfort 1
- Ensure the compression wrap is not too tight to avoid compromising circulation 1
- A buddy splint (taping the injured finger to an adjacent uninjured finger) may provide stability while allowing some function 3
Rest and Protection
- Avoid activities that cause pain in the injured finger 1
- Do not attempt to straighten a deformed finger 1
Follow-up Care
Functional Rehabilitation
- Begin active finger motion exercises as soon as pain allows to prevent stiffness 1
- Stiffness of the fingers can result from pain, swelling, and apprehension 1
- Early finger motion does not adversely affect healing of adequately stabilized injuries 1
Pain Management
- Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to reduce pain and swelling 1
Special Considerations
When to Refer
- If the injured finger is blue or extremely pale, indicating possible vascular compromise 1
- If there is suspicion of fracture or dislocation based on mechanism of injury and physical examination 1
- If symptoms persist despite appropriate initial management 1
Common Pitfalls
- Misdiagnosing more serious injuries as simple sprains - six athletic injuries commonly misdiagnosed as sprained fingers include closed tendon injuries, intra-articular fractures, and volar plate avulsions 2
- Failing to recognize that finger stiffness is one of the most functionally disabling adverse effects of hand injuries 1
- Applying ice directly to the skin, which can cause tissue damage 1
- Using RICE (Rest, Ice, Compression, Elevation) alone, which is not advised as a complete treatment modality 1