What is the treatment for a jammed pinky finger?

Treatment for a Jammed Pinky Finger

For a jammed pinky finger, immediately begin active range of motion exercises of all finger joints while buddy taping the injured pinky to the adjacent ring finger, apply ice for pain control, and use over-the-counter topical NSAIDs as first-line pain management. 1, 2

Immediate Management

Initial Assessment and Imaging

• Obtain anteroposterior, lateral, and oblique radiographs to rule out fractures or dislocations before initiating treatment 1, 3
• Plain radiography is the initial imaging modality of choice for suspected finger trauma 2
• If radiographs are inconclusive but clinical suspicion remains high, CT without IV contrast can confirm suspected fractures 2

Early Motion Protocol

Start active finger motion exercises immediately after injury, even before imaging results are available, as finger stiffness is one of the most functionally disabling complications of finger injuries. 1 This recommendation comes from the American Academy of Orthopaedic Surgeons, which emphasizes that finger motion does not adversely affect adequately stabilized injuries and is an extremely cost-effective intervention that provides significant impact on patient outcome 1.

• Move all finger joints (including the injured pinky) regularly through complete range of motion 1
• This prevents finger stiffness, which can be very difficult to treat after healing and may require multiple therapy visits or surgical intervention 1

Non-Pharmacological Treatment

Buddy Taping

• Tape the injured pinky finger to the ring finger for support and protection 3
• This allows controlled motion while providing stability 3
• Continue buddy taping for 2-4 weeks depending on severity 3

Ice Application

• Apply ice to reduce pain and swelling in the acute phase 1
• Ice is effective at 3 and 5 days post-injury 1

Education and Activity Modification

• Provide education on ergonomic principles and activity pacing 2
• Instruct in joint protection techniques 1
• Thermal modalities (heat or ice) can provide symptomatic relief 2

Pharmacological Management

First-Line: Topical NSAIDs

Topical NSAIDs are the preferred first-line pharmacological treatment over oral medications due to superior safety profile. 2, 1 The European League Against Rheumatism found that topical NSAIDs are equally effective as oral NSAIDs for pain relief but have significantly fewer gastrointestinal side effects 1.

• Apply topical diclofenac or other topical NSAID formulations to the affected finger 1, 2
• Topical NSAIDs have no more GI side effects than placebo (RR = 0.81) 1

Second-Line: Oral Analgesics

• If topical treatments are insufficient, consider oral acetaminophen or ibuprofen for short-term use 1, 2
• Limit duration of oral NSAIDs due to potential cardiovascular and gastrointestinal complications 2

Splinting Considerations

• For more severe injuries with significant pain, consider splinting the metacarpophalangeal joint at 10-15 degrees of flexion 4
• Splinting duration typically 3-6 weeks for soft tissue injuries 4
• However, avoid immobilizing uninjured joints—only restrict motion of the injured structures while allowing other joints to remain mobile 5

Red Flags Requiring Urgent Referral

Refer immediately to orthopedic or hand surgery if: 6, 3

• Fracture with significant angulation (>10 degrees) or displacement 3
• Any malrotation of the finger 6
• Irreducible dislocation 6
• Open fracture or significant soft tissue injury 6
• Volar plate injuries or complex ligamentous disruption 5

Follow-Up and Monitoring

• Review within 1-2 weeks to assess progress 2
• If no improvement within 8-12 weeks, arrange specialist assessment 2
• Monitor using the "four A's": Analgesia, Activities of daily living, Adverse effects, and Aberrant drug taking 2

Common Pitfalls to Avoid

• Do not immobilize the entire hand or wrist for a simple finger injury—this leads to unnecessary stiffness in uninjured joints 1, 5
• Do not delay starting finger motion exercises—early mobilization is critical to prevent long-term stiffness 1
• Do not continue ineffective treatments indefinitely—if a treatment approach isn't working after 2-3 weeks, modify the plan 2
• Do not use prolonged oral NSAIDs—topical formulations provide equivalent pain relief with better safety 1, 2
• Avoid aggressive immobilization, which can worsen outcomes in simple soft tissue injuries 1