I was called to the ER during the morning hours, say around 11 am to see a young girl from the local High School who had an injury to her little finger of her right dominant hand. She was helping roll up the volleyball nets after PE class and got her little finger caught inside one of the small holes in the volleyball net poles and had removed all the skin and contents of the finger from where the finger met the hand to the end of the digit. This is called a “de-gloving” injury. The problem is that there remains attached to the hand, only the bones and ligaments and tendons and the nerves, vessels and all of the skin has been basically removed.
This type of injury is also seen when mechanics or people working around machinery wear their wedding or other rings and get the ring caught in the machinery which pulls off the ring along with the rest of the finger. Even one of our astronauts who went to the moon lost a finger this way jumping off a wagon and his wedding ring caught on the side of the wagon and pulled off all the “meat” from his finger. Insurance companies for a lot of manufacturing facilities forbid the wearing of rings for just this reason. So it’s a pretty well-known problem and results in an amputation at the level the ring was when it left.
The problem wasn’t the injury to this little high school girl, it was the “rest of the story”. She was a GREAT high school varsity basketball player, one of the stars. This was her dominant hand. She is a beautiful young lady and she needed a revision of her amputation to a previously beautiful hand (think rings and pictures and things). Finally, her Dad didn’t have any sons, so he had poured all his sports knowledge into his star player /daughter and thought this would be the end of her career if it couldn’t be repaired.
There is no good operation for this injury except to revise the amputation at the level of the “ring” injury and give the patient a functional hand, minus portions of one digit.
You can imagine the emotional maelstrom that was occurring in the room in the ER. After much discussion, to include cosmetic finger prostheses and a promise that she could still play basketball, I took her to the OR and surgically revised the amputation. There was nothing left past the little finger metacarpal so she lost the finger as it joined the hand.
I had a wonderful compassionate hand therapist at the time and she had many, many interactions with this young lady. We made her appointments with a finger prosthesis manufacturer etc. but after she began using the hand and found out that it didn’t really affect her Basketball game, her entire demeanor and personality snapped back to normal, as did her dad’s and she even declined to have a finger prosthesis made for her. (the prostheses are quite good BTW and look very real, but they are very expensive and are only good for looks, not sports).
She went on to play basketball thru the rest of High School and college, got married and ended up with twins.
She still lives in town here and I see her dad and mom all the time and she runs a pretty profitable little business here.
She does everything she wants with no problems. A great ending to a potentially devastating injury.