Sleeping fingers

[JesseFrank]

On Monday I stabbed in the palm of my hand, about 1.5 cmm behind my fingers, with a screwdriver.

It's quite a small wound and it stopped bleeding quickly. It doesn't hurt much, however it did at that time, but since I have a sleeping feeling on the top of my middle finger but I can move my fingers as usual without hurting.

I thought it would go away, but instead this morning it seems to have spread a little to my pointing finger as well. When I apply pressure on the wound i will feel a tingle in both pointing and middle finger, and right now while typing this, when I hit the keyboard with my pointing finger I will feel a strong tingle in my middle finger.

Anything to worry about ?

[cmsally]

Surely you must have damaged a nerve, better to get it checked out by a doctor / neurologist.

Maybe a branch of the Median nerve. Check out the diagrams for nerves , they are to a certain extent an easy road map to see which could be effected.

[FBN]

There has been an injury to the digital nerve that supplies these 2 fingers. Google images for digital nerves in the hand and you will clearly make out from the anatomical drawings where your injury was and the effects you have now.

If the nerve was completely severed, the loss of sensation would have been immediate. It seems in this case that the nerve was "bruised" and will have a good prognosis for the sensation returning. This injury may mean that the nerve sheath, which is quite tough, is still intact but the nerve at the core (which is very delicate and marrow like) may die as a result of the injury. If the sheath is intact, the nerve will regrow within the sheath but at 1mm per day, may take some time for the sensation to get back to normal.

If the nerve was severed, it may require microsurgery to fix.

This injury is in what hand surgeons call "no man's land" and surgical interventions here requires great skill as structures are microscopic and damage to blood supply can easily occur as the blood vessels run next to the nerves. (Possibly accounting for the amount of bleeding you had at the time of injury).

Best to consult a specialist hand surgeon.

[VocalNeal]

Jesse,

Where do you live?

[JesseFrank]

I understand that consulting a specialist hand surgeon will involve x-rays or whatever to check out the nerves, so will not be a cheap consultation. Also as you say micro surgery will require great skill, I assume that this will also not a cheap event, and are there surgeons in Thailand that have those skills.

How long do you suggest I can look if there is recovery before I take further steps? There was little blood loss for only a few minutes.

@Vocalneal : I live in East Pattaya

[FBN]

If the doc does not suspect any bony injury, which seems very unlikely in your case, no X-rays will be necessary as it will not show any soft tissue or nerve injury. Clinical examination and perhaps a test to test nerve conductivity will be needed.

Difficult to say how long without proper examination and testing but, if the nerve is severed completely, repair should be done within a week or so.

The best hand specialist in Thailand is Dr. Panupan who can be accessed at either: (From Sheryl)

- Siriraj private OPD

http://www.siphhospital.com/en/index.html

(call for hours)

- Phyathai 2 Hospital (Friday evenings)

http://www.phyathai.com/doctorsearchdetail/40188/PYT3/en

- ChaoPhya Hospital - Thursdays

http://www.chaophya.com/web_eng1/doctor_appointment/view_doctor_form.php?id_doctor=63

[VocalNeal]

@Vocalneal : I live in East Pattaya

Sent you a PM.

[giddyup]

I have what's known as a Dupruyen's Contracture on my right hand (hereditary I believe) that causes my ring finger to be pulled down by the tendon, and I can't straighten it. I have put off having any kind of surgery because I know that it requires a very skilled surgeon and I'm just not prepared to take the risk in Thailand. Fortunately it hasn't got any worse over the years, but the palm of my hand does look a bit unsightly, and it can be a tad difficult to do some tasks with that hand.

[JesseFrank]

I have no issues with my fingers, I can use them as normal, and the dumbness is only on one side and slightly on top of the finger.

Yesterday and the day before when I pushed on the wound I would not feel anything strange in the finger, but today it will result in some kind of pressure . Also the tingling when typing only started today.

What would be the consequences if I don't get diagnosed

[FBN]

The nerve damage will not affect any movement, only sensation and the distribution of loss of sensation is exactly anatomically consistent with the site of injury you describe.

Does not seem likely that there is permanent nerve damage but I would not wait more than a week or so. Obviously, if there is any sign of infection such as redness and increased temp at the injury site it should be attended to immediately.

Discussion on a forum has its limitations so best to have at least a local orthopod have a look at it.

[Sheryl]

As FBN says, not likely to need Xrays. Consultation unlikely to run much over 1,000 baht if that.

Better safe tghan sorry esp. when it comes to nerves of your hand. Suggest you see Dr. Panupan as above. Call to be sure he'll be there, as he sometimes attends conferences abroad.

[JesseFrank]

I can inform that by today the numbness in the fingers has almost completely disappeared.

During the past two days I found that massaging and applying pressure to the finger would give very good results.

Yesterday the wound still hurt a little when applying pressure to it, but that has also completely vanished.

I expect it to be completely finished in the next 2 days, so no real need for a specialist, I guess.

Thanks for the help and advice.

[simple1]

I have what's known as a Dupruyen's Contracture on my right hand (hereditary I believe) that causes my ring finger to be pulled down by the tendon, and I can't straighten it. I have put off having any kind of surgery because I know that it requires a very skilled surgeon and I'm just not prepared to take the risk in Thailand. Fortunately it hasn't got any worse over the years, but the palm of my hand does look a bit unsightly, and it can be a tad difficult to do some tasks with that hand.

apparently there is a Thai specialist for treatment. if you're interested go to

http://www.thaivisa.com/forum/topic/460743-dupuytrens-contracture/?hl=+dupuytren

Edited July 19, 2014 by simple1

[JesseFrank]

The numbness on my finger is almost non existent anymore at the moment, however the top middle part of my middle finger still feels some numbness when i sweep over it. Moreover it feels constantly like the skin is burned.

When I rub over the wound in my hand palm it feel like some electric pulse goes through the finger. This is only if I rub towards the finger, rubbing sideways doesn't have this effect, but the wound still feels hurt.

[FBN]

The half of the nerve supplying the mid finger is clearly more damaged than the index finger's. The sensation you feel when touching the wound site may be the nerve healing but, if the nerve sheath was damaged, the nerve (or some bundles of nerve tissue) may grow outside of the nerve sheath and form a neuroma.

Best to give it some time (months) but if it persists, it may need to be removed. The sensation of the mid finger will improve over time partly due to the fact that the nerve supplying the other side of the finger will partially compensate for the side where sensation is lost but this may take up to 18 months or more.