If you’ve noticed that your fingers bend in strange ways, you’re not alone. Many people have crooked or unusually shaped fingers due to various causes. In this article, we’ll explore some of the most common reasons why fingers may bend abnormally and what you can do about it.
Arthritis
One of the most common causes of bent fingers is arthritis. Arthritis is inflammation of the joints that causes pain, swelling, and stiffness. The two main types that affect the hands are osteoarthritis and rheumatoid arthritis.
Osteoarthritis occurs when the cartilage protecting the joints wears down over time. This allows the bones to rub together causing pain, swelling, and changes in joint shape. Osteoarthritis of the hands usually develops at the base of the thumbs and in the middle and end joints of the fingers. It can cause fingers to bend towards the direction of the thumb and take on a zig-zag appearance.
Rheumatoid arthritis is an autoimmune disease where the immune system attacks the joints. It typically starts in the smaller joints of the hands and feet. In the hands, it usually first affects the middle joints of the fingers closest to the knuckles. It causes painful swelling that can permanently bend the fingers towards the palm.
Treating arthritis may help reduce bent fingers. Options include pain medication, anti-inflammatory drugs, hand splints, occupational therapy, and surgery in severe cases. Losing weight if overweight can also help by reducing pressure on the finger joints.
Dupuytren’s Contracture
Dupuytren’s contracture is another common cause of bent fingers. It occurs when fibrous tissue under the palm thickens and tightens, pulling one or more fingers inward towards the palm. It typically affects the ring and pinky fingers, but can occur in any finger.
The ring finger is most commonly affected, followed by the pinky and middle fingers. The condition tends to run in families and occurs most often in older men of Northern European descent. Smoking, diabetes, and some medications are risk factors.
Dupuytren’s has no cure, but treatment options can help straighten the fingers. In the early stages, collagenase injections can help break down the cord-like tissue. For more advanced contractures, procedures like needle aponeurotomy and surgery may be done to remove or release the tightened tissue.
Trigger Finger
Trigger finger, also called stenosing tenosynovitis, is a condition where a finger gets stuck in a bent position and pops or snaps when straightened. It happens when inflammation thickens the sheath around the tendon, obstructing smooth gliding of the tendon through the sheath.
It most commonly affects the thumb and index finger. Symptoms come on gradually and include catching, clicking, or locking of the finger in a flexed position. Trigger finger treatment includes splinting, cortisone injections to reduce inflammation, and surgery if conservative treatments fail.
Finger Fractures
Breaking a finger bone can also lead to a bent finger. Fingers have three bones each known as phalanges. The deformity depends on which bone and where exactly the fracture occurs.
For example, fractures at the end joint nearest the fingernail often heal with the fingertip angulated downwards. Middle and base joint fractures may heal with an outward bend if the fracture is unstable or displaced. Setting the bones properly is key for proper healing.
Treating finger fractures starts with buddy taping the finger to the adjacent finger for stability. More severe fractures require splinting or casting to hold the bones in place during healing. Surgery may be needed for significantly displaced bones to reset them in proper position.
Mallet Finger
Mallet finger is an injury to the thin tendon that straightens the farthest joint of the finger. It’s commonly caused by a sudden forceful bending of the tip of the finger. This tends to happen during sports like baseball and basketball.
It causes the end joint to stay permanently flexed with an inability to straighten on its own. The fingertip may droop down and not align properly with the rest of the finger. Treating mallet finger right away is important to allow proper healing.
Treatment involves splinting the end joint in an extended position for 6-8 weeks. Surgery may be needed if the tendon is completely ruptured. With prompt treatment, mallet finger often heals well with minimal lasting bending of the fingertip.
Swan Neck Deformity
Swan neck deformity is a condition where the finger hyperextends at the middle joint and flexes at the end joint. It causes a finger to resemble a swan’s neck with a dip near the middle and a bend at the tip.
It happens when the small stabilizing muscles in the fingers become imbalanced. Disease processes like rheumatoid arthritis can cause it by weakening the intrinsic muscles closest to the fingernails.
Treating swan neck deformity involves splinting to hold the joints in a corrected position. Sometimes small surgeries are done to tighten or move tendons to help rebalance tension. If due to arthritis, treating the underlying disease is key.
Boutonnière Deformity
Boutonnière deformity causes the middle joint of a finger to become stuck in a bent position while the farthest joint overextends backwards. It makes the finger take on a posture similar to a buttonhole (boutonnière is French for buttonhole).
It occurs due to injury or inflammation of the central tendons of the finger at the middle joint. Rheumatoid arthritis is a common underlying cause. Without treatment, the middle joint can become permanently frozen in a flexed position.
Buddy taping the finger to an adjacent finger or splinting in an extended position helps treat this deformity. Anti-inflammatory medications may also help in early stages. Surgery to repair the damaged tendon and balance tension may be needed in severe cases.
Other Causes
Other conditions that can sometimes lead to bent fingers include:
- Gout – causes buildup of uric acid crystals in the joints
- Psoriatic arthritis – related to the skin condition psoriasis
- Reiter’s syndrome – reactive arthritis that can follow infections
- Kienbock’s disease – avascular necrosis of one of the wrist bones
- Osteochondritis dissecans – loss of blood supply to bone and cartilage
- Congenital deformities – present from birth
- Nerve damage
- Tendon injuries
- Infections
In children, conditions like camptodactyly and clinodactyly can cause some bending of the pinky or little finger inwards towards the ring finger. However, these mild deformities typically don’t affect hand function.
When to See a Doctor
In most cases, you should consult your doctor if you have a finger that looks significantly crooked, swollen, and painful. Seek prompt medical care if:
- The finger is visibly deformed
- Pain, stiffness, swelling comes on suddenly after an injury
- You can’t use or move the finger properly
- The fingertip changes color
- Numbness, tingling, weakness in the finger
- The finger is locking, clicking, or catching when moved
Seeking timely treatment is important to prevent permanent stiffness or dysfunction of the finger. Diagnosing the underlying cause will guide the proper treatment approach.
Diagnosis
To diagnose the cause of a bent finger, the doctor will:
- Ask about your symptoms and medical history
- Examine the hand and finger
- Check range of motion, alignment, swelling
- Look for signs of arthritis
- Test sensitivity and circulation
- Order x-rays – to look at bones and joints
- Order other tests like MRI or bloodwork if needed
Based on the findings, the doctor will determine if an injury, arthritis, neurological issue, or other condition is causing the deformity. An accurate diagnosis is important for effective treatment.
| Condition | Signs | Tests |
|---|---|---|
| Arthritis | Joint swelling, reduced motion, bumps on fingers | X-rays, bloodwork |
| Trigger finger | Finger catching or locking in bent position | Physical exam |
| Dupuytren’s contracture | Palmar thickening, pits/nodules in palm, bent fingers | Physical exam |
| Fracture | Pain, swelling, bruising after injury | X-rays |
| Tendon injury | Difficulty extending or bending after trauma | MRI |
Treatment
Treatment depends on the underlying cause but may include:
- Splinting – to immobilize and straighten the finger
- Injections – cortisone to reduce inflammation, collagenase to break down cords in Dupuytren’s contracture
- Surgery – to repair tendons or release tightened tissues and realign bones
- Medications – NSAIDs, DMARDs for inflammatory arthritis
- Occupational therapy – exercises and techniques to improve hand function
- Lifestyle changes – quit smoking, lose weight to reduce pressure on joints
The goal is to straighten and align the finger properly so you can use your hand normally. This may require a combination of conservative care and procedures depending on the diagnosis.
Prevention
You can take some preventive measures to lower your risk of finger deformities:
- Wear protective gloves for sports like baseball, hockey, football
- Warm up hands properly before sports
- Get prompt treatment for injuries before they worsen
- Do finger stretches and exercises to keep joints flexible
- Manage medical conditions like arthritis and diabetes
- Quit smoking to avoid diseases that affect finger function
While you can’t prevent all causes of bent fingers, these steps may help reduce your risks and keep the small joints in your hands healthy.
Outlook
The prognosis for bent fingers depends on the underlying cause. Mild changes from arthritis or aging may progress slowly over time. But other cases like injuries or nerve damage can sometimes be corrected with appropriate treatment.
For conditions like advanced arthritis and Dupuytren’s contracture, bent fingers can’t be reversed completely. But treatment can still straighten fingers and restore hand function. Working with your doctor can help get your fingers moving better, reduce pain, and improve dexterity.
When to See an Hand Surgeon
You may need referral to a hand and plastic surgeon if:
- Finger deformity is severe or worsening
- You’ve tried conventional treatments without improvement
- Your hand function is significantly impaired
- You need procedures like surgery or collagenase injections
Hand specialists have advanced training to treat all conditions affecting the intricate bones, joints, nerves, and soft tissues of the hands and fingers. They can accurately diagnose the issue and provide the most effective therapies.
Questions for the Doctor
If you have a bent finger, asking your doctor the right questions can help you understand what’s causing it and how to get it treated properly. Some questions to ask include:
- What is most likely causing my bent finger – injury, arthritis, other condition?
- Will I need any tests like x-rays or MRI to confirm the diagnosis?
- Is my finger likely to straighten back out or is the deformity permanent?
- What treatment options do I have – splinting, therapy, shots, surgery?
- What is the outlook for hand function with this condition?
- Do I need to modify any activities to avoid worsening the deformity?
- Could this be related to an underlying disease like rheumatoid arthritis?
- How can I prevent complications and deformities in my other fingers?
Don’t hesitate to speak up about any concerns you have regarding bent fingers. Your doctor can create a treatment plan tailored to your individual case.
Conclusion
If you notice your fingers looking increasingly crooked and bent, don’t ignore it. Have it evaluated promptly to get a proper diagnosis. With treatment ranging from splinting and therapy to medications, injections, or surgery, most causes of bent fingers can be improved.
While some deformities can’t be fully reversed, straightening fingers as much as possible is key to regaining optimal hand function. Working closely with your doctor increases the chances of successfully straightening bent fingers and getting your hands moving freely again.
