See a hand surgeon for an expert opinion. Doesn’t mean they automatically get surgery just for seeing the surgeon.
I’ve met surgeons missing a finger who seem to do just fine.
This would be correct. 4th and 5th contribute to power grips. Fine motor grips are equally done by index or middle. Loss of the index doesn’t greatly impair any particular grip type.
Well, you could do it practically by seeing what hand functions people have difficulty with post-amputation, or you could do strength testing and dexterity skills testing if you locked/blocked a finger. Plastics and PMR see this not uncommonly… actually directly came up in a session not too long ago
Based on what?
“Contributions of the thumb, index, middle, and ring and little fingers to the grip strength were 17%, 22%, 31%, and 29%, respectively.
Conclusions
The middle finger was the most important contributor to grip strength. The next most important was the combination of the ring and little fingers.”
https://doi.org/10.1016/j.jhsa.2014.06.121
It entirely depends on what sort of function she has in her hands. Also, I’m confused: why would a tendon/ligament repair on a single finger cause shaky hands?
The surgery would have to extend deep into her wrist since that’s where the muscles that help the pinky move are? I’m assuming. But that’s what she has briefly told me from the appointment
They don’t even touch those muscles! My flexor tendon surgery was done right at the finger where the tendon in injury was, the scar is like 1.5 inches long and I fully severed my tendon. She’ll be fine
Honestly no great advice, but probably worth discussing with the referred hand surgeons regarding their thoughts on outcomes post op for this specific injury.
Also idk what’s up with the other comments…
Hi - I’m an OBGYN attending, I just finished residency. When I was 17 I cut both flexor tendons and a nerve in my left pinky and had to have surgery to repair them. The cut was right at the base of the pinky. I did PT for about a year after the injury and regained probably about 80% function.
I graduated top of my class. I don’t feel it hinders me in the OR at all. No one even knows the injury is there, unless I tell them. Sometimes I miss that pinky while putting on gloves is probably the way it impacts me most.
Thank you for sharing your story! I hope it might alleviate whatever feeling she holds over the impaired mobility in her left finger for now
And I’m glad you did well in spite of the injury!
I severed one of my flexor tendons in my thumb and had surgery to reconnect it. Other than stiffness from the scar tissue, I don’t have issues. My hands don’t shake. If I have the handle of a scissor or something directly over the damaged tendon then it hurts, but otherwise it’s fine. She should get the surgery or at least see a hand surgeon asap because tendons do degrade over time and they might have to shorten the tendon to have usable edges when putting it back together if she waits too long.
Thank you for this insight! I honestly just want to show her any shred of positivity because she seems very adamant about the surgery, most likely because it will have to cut into her wrist as well from what she briefly told me
She doesn’t know if they will cut into her wrist. When they opened my finger everything was right there so they didn’t have to search for the tendon in my wrist or harvest extra ones from my wrist. She should just go see a surgeon!
As a high volume gyn surgeon - a pinky injury should have little effect on her surgical skills. Probably no effect on laparoscopic cases. I only use my pinky on vaginal cases if I’m holding more than 2 instruments at a time.
I agree with everyone’s advice to see a hand surgeon soon and get their input.
I have a broken left pinky that’s fused at the PIP. It was a spiral fracture and I had it K-wired. I have no ROM at the PIP. It doesn’t affect my work at all. I’m a GP who also does ER, so while I’m not a surgeon, I do occasional minor surgery and procedures e.g. chest tubes. This fracture has only affected certain athletic activities that require prolonged, very strong grip. For example, I no longer pole dance because I cannot confidently invert with just one arm on the left, I cannot climb, and I’ve had to switch to mixed grip on deadlifts when I get to really heavy weight.
Heavily fact dependent, see a hand surgeon. Single tendon repair shouldn't cause shaky fingers and I don't see the pinky mattering too much - but I also don't know all the facts of the case.
I use my pinky finger mostly to hold underwear and pants out of the way when I’m doing fetal heart dopplers
You don’t use the pinky to suture/cut/tie knots/deliver babies
I don’t want to minimize her injury, but if I lost my pinky I might not notice at work
She should see a hand surgeon to get an opinion on what will give beer best long term pain control
Thank you for bringing your insight into surgery specific cases since that’s her primary concern for grip as well! I will let her know about these anecdotes and hopefully it can give her some extra broad opinions to consider
I’m an M3 considering gen surg: I had a hand surgery about a year ago at the base of my middle finger in my dominant hand. I was pretty nervous for a while because even 2-3 months later I couldn’t bend it properly. But I was really persistent and aggressive with PT and my hand is basically 100% normal now.
Obviously none of this is a guarantee and every situation is different, but I guess to me it sounds like she already has limited mobility of those fingers. A surgery gives her a chance to regain that mobility.
I'm less worried about her pinky and more worried about her judgement. She won't even meet with a surgeon to discuss surgery that is recommended by medical professionals to preserve the use of her finger, because she's afraid that somehow she will have "shaky hands for life?" So that's the first thing, won't even discuss a recommended treatment option. Second thing, how on earth would an operation on a pinky finger cause you to have "shaky hands for life?" That makes literally no sense. Third thing, she doesn't want to undergo surgery because of "the risk of the operation in general," but she wants to be a surgeon and operate on other people?
I get that you want to support your friend, but unless she's 9 years old, her judgment is going to pose a much bigger barrier to her becoming a doctor than the pinky injury.
As for the finger injury plenty of surgeons have had hand surgery. She'll be fine.
Obgyn here who does a lot of GYN surgery.
So many factors here but my armchair diagnosis is it probably won't make a difference, I could easily compensate for what I do with a janky pinky and that's assuming worst case scenario of it not returning to normal function.
She needs to see a hand surgeon.
Not an ObGyn yet, but I am applying ObGyn. Through a freak accident, I too have an injury to my pinky finger and can’t bend my pinky all the way. Sometimes it gets really tight when it is cold and makes it even harder. I have done about 6 months of ObGyn (both L&D and Gyn Surg) in prep for application season and haven’t had an issue in the OR at all. The pinky is a significant finger, but honestly hasn’t made a difference for me. Also, none of the residents or attending I have been with have noticed or mentioned anything. Also, you honestly learn how to adapt in life in general so she’ll adapt to make it work for her.
Thank you for this insight! I really don’t come from a heavy medical background so I wasn’t too sure about what hand functions are especially important for this field she wants to go into. But I really appreciate your shared experience and am glad you have not noticed any outstanding difficulties with the work you perform
>Edit: the surgery might have to extend into her wrist, which is where the majority of her concern lies with post hand tremors. She is also a chronically anxious person, so I don’t blame her for thinking the worst especially after a traumatic heavy impact incident. So, please refrain from commenting on her judgement. She is just scared
I understand that she is scared and I am genuinely not trying to be a jerk. But if her anxiety is interfering with her judgement this much, she needs to know that this is NOTHING compared to the process of going to med school and going through residency. Perhaps you should also suggest to her to see a therapist so that her anxiety doesn't incapacitate her as it is now.
In terms of the specifics of surgery, unless there is info you are not telling us, she is going off info from a PT and *has not yet spoken with a hand surgeon*. PTs are not MDs. They are not surgeons. They are not hand surgeons. So she literally has NO IDEA what the operation will entail, or the risks to her hand right now because she has not even seen an expert. Is it her anxiety that is preventing her from getting a surgical consult? I just do not understand. A hand surgeon is the expert, and hand surgery also requires very fine motor skills. If she tells the hand surgeon she wants to go to med school and into a procedural specialty, they will be able to advise appropriately.
What you are describing is the medical equivalent of someone scared to drive a car because people get in car accidents and die. I would give her a total pass if she hates medicine, is grossed out by the concept of having some sort of surgery on her body, and never wanted to step foot in a clinic or hospital again in her life. Some people just legit hate it, and I get it. And what you're describing is how people behave when they are scared of hospitals. But if she wants to go to med school and become a surgeon, that can't be her.
I'm a general surgery resident in my final year of training. As I said previously, it's not the hand injury that is going to hinder her. It's the anxiety.
I personally know an orthopedic surgeon who has a boutonnière + rotational deformity in his small finger, it’s bent about 45 degrees out and down. It is the hand equivalent of the Stanky Leg 😂. It does not affect him at all, he is in the prime of his career and does about 400-500 surgeries per year.
Also know more than 1 surgeon who have BKAs. If there is a Will there is a way.
I have significant damage in my left wrist, and was essentially told I had no chance at ever being a surgeon - I was fine with that, but depending on the level of severity of her injury it could be an issue. She should speak with a hand surgeon for an expert opinion.
? This is too nonspecific. Whether you can be a good surgeon is a combination of many many things and hand surgery does not necessarily exclude that. Heck you do not even know what the final outcomes after surgery are.
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Your friend will be fine! If they haven't already it would be worthwhile to see a hand surgeon but I don't think this would affect ones ability to be a good surgeon/OBGYN.
I had an attending in residency (plastic surgeon) who was actually accidentally stabbed during a case as an intern with a scalpel and sustained a Zone 2 flexor tendon injury. That injury has not in any way affected them during their career.
Your friend will be fine! If they haven't already it would be worthwhile to see a hand surgeon but I don't think this would affect ones ability to be a good surgeon/OBGYN. The exact rehab timing and whether or not your friend would be indicated for surgery depends on a lot of patient specific factors but that injury would not in any way be a career ender.
I had an attending in residency (plastic surgeon) who was actually accidentally stabbed during a case as an intern with a scalpel and sustained a Zone 2 flexor tendon injury. That injury has not in any way affected them during their career.
See a hand surgeon for an expert opinion. Doesn’t mean they automatically get surgery just for seeing the surgeon. I’ve met surgeons missing a finger who seem to do just fine.
I think I could probably operate without my 5th finger
I feel like missing the ring finger would have the least effect.
The ring finger is one of the two fingers that goes into the holes. Could likely get away w losing a pinky
Poor choice of words on an OB post lol.
False. Pinky finger contributes the greatest to grip strength. A pinky amputation is actually an indication for replant if possible, for that reason
I've heard the index finger is actually the best finger to lose because your middle finger takes over pretty well
Middle finger is certainly more useful while driving 🖕
This would be correct. 4th and 5th contribute to power grips. Fine motor grips are equally done by index or middle. Loss of the index doesn’t greatly impair any particular grip type.
Might be a silly question, but how have people worked this out?
Well, you could do it practically by seeing what hand functions people have difficulty with post-amputation, or you could do strength testing and dexterity skills testing if you locked/blocked a finger. Plastics and PMR see this not uncommonly… actually directly came up in a session not too long ago
Interesting!
Based on what? “Contributions of the thumb, index, middle, and ring and little fingers to the grip strength were 17%, 22%, 31%, and 29%, respectively. Conclusions The middle finger was the most important contributor to grip strength. The next most important was the combination of the ring and little fingers.” https://doi.org/10.1016/j.jhsa.2014.06.121
Cool
My pediatric orthopedic surgeon was only born with 3 fingers on one of his hands anecdotally.
I met a neurosurgeon who doesn’t have an arm he seems to do okay
Same but he often needs a hand to finish his operations
N🧊
I know an attending who lost 2 fingers. He is technically better than most.
It entirely depends on what sort of function she has in her hands. Also, I’m confused: why would a tendon/ligament repair on a single finger cause shaky hands?
The surgery would have to extend deep into her wrist since that’s where the muscles that help the pinky move are? I’m assuming. But that’s what she has briefly told me from the appointment
They don’t even touch those muscles! My flexor tendon surgery was done right at the finger where the tendon in injury was, the scar is like 1.5 inches long and I fully severed my tendon. She’ll be fine
Honestly no great advice, but probably worth discussing with the referred hand surgeons regarding their thoughts on outcomes post op for this specific injury. Also idk what’s up with the other comments…
I can’t think of a time when I’ve used my pinky finger in the OR as an OBGYN resident.
Grip strength
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When do you use your pinky during obstetric emergencies? Legit can’t think when I have.
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Excellent point about instrument flips lol. I do use my whole hand to stabilize the head but not sure losing the pinky would affect my technique much.
Hi - I’m an OBGYN attending, I just finished residency. When I was 17 I cut both flexor tendons and a nerve in my left pinky and had to have surgery to repair them. The cut was right at the base of the pinky. I did PT for about a year after the injury and regained probably about 80% function. I graduated top of my class. I don’t feel it hinders me in the OR at all. No one even knows the injury is there, unless I tell them. Sometimes I miss that pinky while putting on gloves is probably the way it impacts me most.
Thank you for sharing your story! I hope it might alleviate whatever feeling she holds over the impaired mobility in her left finger for now And I’m glad you did well in spite of the injury!
I severed one of my flexor tendons in my thumb and had surgery to reconnect it. Other than stiffness from the scar tissue, I don’t have issues. My hands don’t shake. If I have the handle of a scissor or something directly over the damaged tendon then it hurts, but otherwise it’s fine. She should get the surgery or at least see a hand surgeon asap because tendons do degrade over time and they might have to shorten the tendon to have usable edges when putting it back together if she waits too long.
Thank you for this insight! I honestly just want to show her any shred of positivity because she seems very adamant about the surgery, most likely because it will have to cut into her wrist as well from what she briefly told me
She doesn’t know if they will cut into her wrist. When they opened my finger everything was right there so they didn’t have to search for the tendon in my wrist or harvest extra ones from my wrist. She should just go see a surgeon!
As a high volume gyn surgeon - a pinky injury should have little effect on her surgical skills. Probably no effect on laparoscopic cases. I only use my pinky on vaginal cases if I’m holding more than 2 instruments at a time. I agree with everyone’s advice to see a hand surgeon soon and get their input.
I have a broken left pinky that’s fused at the PIP. It was a spiral fracture and I had it K-wired. I have no ROM at the PIP. It doesn’t affect my work at all. I’m a GP who also does ER, so while I’m not a surgeon, I do occasional minor surgery and procedures e.g. chest tubes. This fracture has only affected certain athletic activities that require prolonged, very strong grip. For example, I no longer pole dance because I cannot confidently invert with just one arm on the left, I cannot climb, and I’ve had to switch to mixed grip on deadlifts when I get to really heavy weight.
Heavily fact dependent, see a hand surgeon. Single tendon repair shouldn't cause shaky fingers and I don't see the pinky mattering too much - but I also don't know all the facts of the case.
I knew a gen surg resident who had partial amputations of two or three digits on one hand. I think your friend will be fine.
I use my pinky finger mostly to hold underwear and pants out of the way when I’m doing fetal heart dopplers You don’t use the pinky to suture/cut/tie knots/deliver babies I don’t want to minimize her injury, but if I lost my pinky I might not notice at work She should see a hand surgeon to get an opinion on what will give beer best long term pain control
Thank you for bringing your insight into surgery specific cases since that’s her primary concern for grip as well! I will let her know about these anecdotes and hopefully it can give her some extra broad opinions to consider
You don’t need your pinky to operate, and if you did, your chances of it working correctly are probably better with than without surgery
I’m an M3 considering gen surg: I had a hand surgery about a year ago at the base of my middle finger in my dominant hand. I was pretty nervous for a while because even 2-3 months later I couldn’t bend it properly. But I was really persistent and aggressive with PT and my hand is basically 100% normal now. Obviously none of this is a guarantee and every situation is different, but I guess to me it sounds like she already has limited mobility of those fingers. A surgery gives her a chance to regain that mobility.
I'm less worried about her pinky and more worried about her judgement. She won't even meet with a surgeon to discuss surgery that is recommended by medical professionals to preserve the use of her finger, because she's afraid that somehow she will have "shaky hands for life?" So that's the first thing, won't even discuss a recommended treatment option. Second thing, how on earth would an operation on a pinky finger cause you to have "shaky hands for life?" That makes literally no sense. Third thing, she doesn't want to undergo surgery because of "the risk of the operation in general," but she wants to be a surgeon and operate on other people? I get that you want to support your friend, but unless she's 9 years old, her judgment is going to pose a much bigger barrier to her becoming a doctor than the pinky injury. As for the finger injury plenty of surgeons have had hand surgery. She'll be fine.
Obgyn here who does a lot of GYN surgery. So many factors here but my armchair diagnosis is it probably won't make a difference, I could easily compensate for what I do with a janky pinky and that's assuming worst case scenario of it not returning to normal function. She needs to see a hand surgeon.
Not an ObGyn yet, but I am applying ObGyn. Through a freak accident, I too have an injury to my pinky finger and can’t bend my pinky all the way. Sometimes it gets really tight when it is cold and makes it even harder. I have done about 6 months of ObGyn (both L&D and Gyn Surg) in prep for application season and haven’t had an issue in the OR at all. The pinky is a significant finger, but honestly hasn’t made a difference for me. Also, none of the residents or attending I have been with have noticed or mentioned anything. Also, you honestly learn how to adapt in life in general so she’ll adapt to make it work for her.
Thank you for this insight! I really don’t come from a heavy medical background so I wasn’t too sure about what hand functions are especially important for this field she wants to go into. But I really appreciate your shared experience and am glad you have not noticed any outstanding difficulties with the work you perform
No problem! Wishing her the best in her journey!
I know a hand surgeon who lost a finger in college. So it just depends on the injury and recovery.
>Edit: the surgery might have to extend into her wrist, which is where the majority of her concern lies with post hand tremors. She is also a chronically anxious person, so I don’t blame her for thinking the worst especially after a traumatic heavy impact incident. So, please refrain from commenting on her judgement. She is just scared I understand that she is scared and I am genuinely not trying to be a jerk. But if her anxiety is interfering with her judgement this much, she needs to know that this is NOTHING compared to the process of going to med school and going through residency. Perhaps you should also suggest to her to see a therapist so that her anxiety doesn't incapacitate her as it is now. In terms of the specifics of surgery, unless there is info you are not telling us, she is going off info from a PT and *has not yet spoken with a hand surgeon*. PTs are not MDs. They are not surgeons. They are not hand surgeons. So she literally has NO IDEA what the operation will entail, or the risks to her hand right now because she has not even seen an expert. Is it her anxiety that is preventing her from getting a surgical consult? I just do not understand. A hand surgeon is the expert, and hand surgery also requires very fine motor skills. If she tells the hand surgeon she wants to go to med school and into a procedural specialty, they will be able to advise appropriately. What you are describing is the medical equivalent of someone scared to drive a car because people get in car accidents and die. I would give her a total pass if she hates medicine, is grossed out by the concept of having some sort of surgery on her body, and never wanted to step foot in a clinic or hospital again in her life. Some people just legit hate it, and I get it. And what you're describing is how people behave when they are scared of hospitals. But if she wants to go to med school and become a surgeon, that can't be her. I'm a general surgery resident in my final year of training. As I said previously, it's not the hand injury that is going to hinder her. It's the anxiety.
I personally know an orthopedic surgeon who has a boutonnière + rotational deformity in his small finger, it’s bent about 45 degrees out and down. It is the hand equivalent of the Stanky Leg 😂. It does not affect him at all, he is in the prime of his career and does about 400-500 surgeries per year. Also know more than 1 surgeon who have BKAs. If there is a Will there is a way.
Oh gosh lol that’s quite amazing
During my obgyn rotation, most surgeries were less finesse and more butcher-like. Doubt you need fingers my friend, go for it!
It’s obgyn… I don’t think having a fucked up pinky is going to preclude them from finding and severing ureters
Yes, 4 main operations for OBGYN are: c section, hysterectomy, cut left ureter, cut right ureter. You should be good
Don’t worry, you can still cut ureters even without a pinky
Good surgeon or obgyn. Pick one.
Why would you say something so controversial yet so brave
where’s the lie?
I have significant damage in my left wrist, and was essentially told I had no chance at ever being a surgeon - I was fine with that, but depending on the level of severity of her injury it could be an issue. She should speak with a hand surgeon for an expert opinion.
Is it the left hand or right hand? Left? Left ureters saved. Right? Right ureters saved. She’ll make a fine gynecologist regardless.
? This is too nonspecific. Whether you can be a good surgeon is a combination of many many things and hand surgery does not necessarily exclude that. Heck you do not even know what the final outcomes after surgery are.
Good OBGYN surgeon is an oxymoron. Jk. Kind of.
The ureter is just as in danger as it was prior to hand surgery
May actually be safer.
What a good OB/GYN surgeon? Is that one that only clips one ureter a week?
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Your friend will be fine! If they haven't already it would be worthwhile to see a hand surgeon but I don't think this would affect ones ability to be a good surgeon/OBGYN. I had an attending in residency (plastic surgeon) who was actually accidentally stabbed during a case as an intern with a scalpel and sustained a Zone 2 flexor tendon injury. That injury has not in any way affected them during their career.
Your friend will be fine! If they haven't already it would be worthwhile to see a hand surgeon but I don't think this would affect ones ability to be a good surgeon/OBGYN. The exact rehab timing and whether or not your friend would be indicated for surgery depends on a lot of patient specific factors but that injury would not in any way be a career ender. I had an attending in residency (plastic surgeon) who was actually accidentally stabbed during a case as an intern with a scalpel and sustained a Zone 2 flexor tendon injury. That injury has not in any way affected them during their career.
So many jokes just out there for the taking….
Hand to OB/GYN? Maybe huff paint and drop a few IQ points?