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Anyone else experienced a volar PIP fracture-dislocation *with* central slip avulsion?
1 month(s) ago • 132 views • 10 replies
ZHBlue beltVerified
1 month(s) ago
I know this is a fairly specific and uncommon injury, but I'm curious if anyone here has dealt with a volar PIP fracture-dislocation with a central slip avulsion.
I injured my right pinky during training and ultimately required surgical fixation with a plate/screws and a K-wire across the PIP joint. The K-wire was removed today at about 3.5 weeks post-op. My PIP is understandably extremely stiff right now with very little movement, although DIP motion is considerably better. I've started the ROM exercises prescribed by my hand therapist.
I'm not looking for medical advice and am following the guidance of my surgeon and hand therapist. I'm specifically interested in finding anyone who has experienced this same injury pattern, or something very close to it, since there doesn't seem to be much firsthand information out there about this specific injury (especially in relation to grappling).
If you've had one, I'd be interested to hear what your recovery was like: how your PIP ROM progressed after immobilization, how much function you eventually regained, and, particularly for BJJ, what your eventual return to drilling and rolling looked like.
Even if your injury wasn't identical, I'd be interested in hearing from anyone whose injury involved a volar PIP fracture-dislocation and central slip injury requiring surgical fixation.
I injured my right pinky during training and ultimately required surgical fixation with a plate/screws and a K-wire across the PIP joint. The K-wire was removed today at about 3.5 weeks post-op. My PIP is understandably extremely stiff right now with very little movement, although DIP motion is considerably better. I've started the ROM exercises prescribed by my hand therapist.
I'm not looking for medical advice and am following the guidance of my surgeon and hand therapist. I'm specifically interested in finding anyone who has experienced this same injury pattern, or something very close to it, since there doesn't seem to be much firsthand information out there about this specific injury (especially in relation to grappling).
If you've had one, I'd be interested to hear what your recovery was like: how your PIP ROM progressed after immobilization, how much function you eventually regained, and, particularly for BJJ, what your eventual return to drilling and rolling looked like.
Even if your injury wasn't identical, I'd be interested in hearing from anyone whose injury involved a volar PIP fracture-dislocation and central slip injury requiring surgical fixation.
MBlack beltVerified
1 month(s) ago
I have sent you mine and the hand-strength book I am writing. Hopefully my experiences and training help you with your recovery. My injury is with me every day; it still limits the movement of two fingers drastically and the thumb. However, as I mentioned, the accident happened before I was even a blue belt. At that time, I thought I was done, and then someone told me to look up Jean Jacques Machado; he was missing fingers and not just limited in ROM of the DIP or PIP joints! That kicked me off to learn more about how to strengthen what I have and make it the best I can, while learning to modify positions and grips so they work for me.
I am sure you will do great!
I am sure you will do great!
MBlack beltVerified
1 month(s) ago
Maybe you can be my first testimonial (besides me) on how the strength exercises work!
ZHBlue beltVerified
1 month(s) ago
I definitely want to incorporate the well laid out regimen you've crafted; soon! Right now I currently have nearly 0 degree PIP AROM/PROM and maybe very little DIP AROM/PROM. Once I get further along I'm definitely referring back to your material. 🙏 Thanks again for that!
PGBlue beltVerified
1 month(s) ago
I just removed the splint for my mallet finger (DIP extensor tendon rupture) for the first time in 6 weeks today. I know it's not the same injury, but the DIP joint does not want to move at all. I know I'm in good shape right now because it wiggles in both directions, by a few degrees, so the rest is gradual return to ROM and strength. Mine did not come with a fracture, so no surgery was indicated. Is the reason you got a plate because the dislocation was so severe? My friend who is an ortho told me that fractures of this type of injury often heal better than soft-tissue only injuries. I hope we both get our pinkies back to as much function as possible, and quickly!
ZHBlue beltVerified
1 month(s) ago
I just removed the splint for my mallet finger (DIP extensor tendon rupture) for the first time in 6 weeks today. I know it's not the same injury, but the DIP joint does not want to move at all. I know I'm in good shape right now because it wiggles in both directions, by a few degrees, so the rest is gradual return to ROM and strength. Mine did not come with a fracture, so no surgery was indicated. Is the reason you got a plate because the dislocation was so severe? My friend who is an ortho told me that fractures of this type of injury often heal better than soft-tissue only injuries. I hope we both get our pinkies back to as much function as possible, and quickly!
Yeah, the dislocation wasn't stable, and simply resetting it wouldn't have kept it in place because the piece of bone where the tendon attaches had fractured. That's why they had to insert the plate and screws along with a K-wire. My DIP joint is progressing reasonably well, but my PIP joint is really struggling to make range of motion progress four weeks after surgery. I suppose that's understandable, considering the K-wire was removed three and a half weeks post-surgery, essentially immobilizing my PIP joint and preventing any movement during that period. I just need to keep up with my physical therapy and continue doing my best, hoping to see some signs of improvement in the coming weeks. Do keep me updated on your journey. By the way, how did your injury happen?
MBlack beltVerified
1 month(s) ago
Yeah, the dislocation wasn't stable, and simply resetting it wouldn't have kept it in place because the piece of bone where the tendon attaches had fractured. That's why they had to insert the plate and screws along with a K-wire. My DIP joint is progressing reasonably well, but my PIP joint is really struggling to make range of motion progress four weeks after surgery. I suppose that's understandable, considering the K-wire was removed three and a half weeks post-surgery, essentially immobilizing my PIP joint and preventing any movement during that period. I just need to keep up with my physical therapy and continue doing my best, hoping to see some signs of improvement in the coming weeks. Do keep me updated on your journey. By the way, how did your injury happen?
How are you doing? Getting any movement back yet?
ZHBlue beltVerified
1 month(s) ago
How are you doing? Getting any movement back yet?
Honestly, I’ve been feeling much better about my rehab over the last couple of days. The swelling, inflammation, and pain have all been consistently improving quite a bit. Now I’m starting to notice the stiffness between HEP sessions more than anything, which really isn’t a big deal. If anything, it motivates me to get everything loosened up again during the next session.
Submerging my hand in hot water for a few minutes before doing my exercises has also been amazing. The progress is still small, but it’s definitely measurable, which feels great. I’m hyped to see my OT today, go over the progress, and see what they think.
Submerging my hand in hot water for a few minutes before doing my exercises has also been amazing. The progress is still small, but it’s definitely measurable, which feels great. I’m hyped to see my OT today, go over the progress, and see what they think.
ZHBlue beltVerified
1 month(s) ago
This was yesterday evening, and I feel like even this morning I've made a small amount of progress in my PIP AROM. 🤌
MBlack beltVerified
1 month(s) ago
Honestly, I’ve been feeling much better about my rehab over the last couple of days. The swelling, inflammation, and pain have all been consistently improving quite a bit. Now I’m starting to notice the stiffness between HEP sessions more than anything, which really isn’t a big deal. If anything, it motivates me to get everything loosened up again during the next session. Submerging my hand in hot water for a few minutes before doing my exercises has also been amazing. The progress is still small, but it’s definitely measurable, which feels great. I’m hyped to see my OT today, go over the progress, and see what they think.
Nothing quite like the warm wax treatment! Warm water does the trick as well. I found the moist heat from wet towels worked good for me better than warm water. But the hot wax at the OT was the best!
PGBlue beltVerified
4 week(s) ago
Glad you are making progress! You are only one week out from having the wire removed, your picture shows as much or better progress than mine at the same point.
I haven't been doing any kind of OT/PT for mine, and I'm 50/50 on whether I should call my PT or not. The doc said just to gradually spend more time out of the brace over the course of two weeks, and I'm halfway through that process today. Very little ROM coming back so far, but there is zero lag at the finger tip, which I'm kind of keeping as my priority. From what I understand, I could probably push a little harder and get the ROM back faster, but the end result will probably be a little crooked. So far, as soon as I notice anything below 100% straight, I go back in the splint for another hour or two, and then I get full straightness when I come back out of it.
My injury happened when a white belt full-body spazzed a grip break when I was already letting go, hence the extensor tendon popped because I was trying to extend the finger when it got caught in the gi and yanked. I have done one class with some moderate one-handed rolling since the injury, and looking forward to being able to train more or less normally soon, with some extra support for the finger.
I will have to try the warm water bath!
I haven't been doing any kind of OT/PT for mine, and I'm 50/50 on whether I should call my PT or not. The doc said just to gradually spend more time out of the brace over the course of two weeks, and I'm halfway through that process today. Very little ROM coming back so far, but there is zero lag at the finger tip, which I'm kind of keeping as my priority. From what I understand, I could probably push a little harder and get the ROM back faster, but the end result will probably be a little crooked. So far, as soon as I notice anything below 100% straight, I go back in the splint for another hour or two, and then I get full straightness when I come back out of it.
My injury happened when a white belt full-body spazzed a grip break when I was already letting go, hence the extensor tendon popped because I was trying to extend the finger when it got caught in the gi and yanked. I have done one class with some moderate one-handed rolling since the injury, and looking forward to being able to train more or less normally soon, with some extra support for the finger.
I will have to try the warm water bath!
