Joe A Shaw PA-C - 4/30/2012

Question
I wondered if you could answer this, since Google only gives me information on sprains.  Several weeks ago - 2 months, I think - I accidently shot myself in the hand with a staple gun.  Ouch.  Isn't the first time, probably won't be the last.  I've had puncture wounds before and know how to treat them, but this time was different: the staple entered the underneath side of my ring finger with one prong in the center of the first joint muscle and the second prong right smack in the center of the first knuckle (PIP).  The staple went in about 1/4".  It was swollen for a few days but seemed to heal fine and without infection. It didn't really hurt to bend, except when the swelling wouldn't allow it.  But that punctured knuckle is still sore and stiff 2 months later, and the second knuckle (DIP) is a little stiff as well.  It isn't swollen or discolored, but it is a little tender if I squeeze it, as well as the originally punctured muscle.  I make and repair dolls, so I'm constantly using my hands for sculpting, carving, and sewing.  This injury occured on my dominant hand (left).  Does it normally take so long for a hand joint injury to heal?  I haven't been able to find any information on the internet about knuckle puncture injuries, just sprains.  Is there something I should be doing, or just wait it out?  The punctures have long since healed.

Answer
Maegan, You really need to get this checked on by a hand orthopedist..not walk-in clinic..you could have an infection that is sequestered off within your bone or along tendon or tendon sheath.Since it is sequestered off it may not present like "normal" infection you are thinking of.. These puncture wounds can seem benign but can be very serious. We have bacteria on our skin and the puncture drives these bacteria into the joint,tendon,bone etc..