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Nerve damage after a dog bite?

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I had a canine tooth slice across the pad on my left pinkie finger right at the bend closest to the tip. It did not hit the bone, but was rather deep. The stitches were removed five days ago, and yet the whole finger remains swollen. Not only this, but I have lost all feeling in the left section of the end of that same finger past the wound. Initially all feeling was lost from the wound to the tip, but some returned as the wound healed. Being that it feels like I'm hitting a nerve every time I (accidentally) impact the wound area, I'm concerned that this could be nerve damage. I would rather not get surgery for something as minor as a numb area on a finger, but at the same time it impacts use of that finger for typing, guitar playing, etc. I know I should see my doctor again for advice, but it's Saturday and I'm looking for advice prior to my visit on Monday.
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replied December 11th, 2011
Especially eHealthy
Bmart,

Yes, it sounds like you have some injury to the digital nerve.

You have two digital nerves in each finger. They run up both sides of the finger, giving off tiny nerve branches along the way, going both dorsal (top) and volar (palmar), and in the midline, they overlap just a little.


So, when you were bitten, the injury probably bruised one nerve (which has awakened), but the other one was damaged more significantly.

The feeling you are getting ("like hitting a nerve") is exactly that. When injured, the nerve forms what is called a neuroma. Then when a neuroma is tapped, it can feel like an electrical shock or tingling. This is called a Tinel's sign, which is a sign of nerve irritation or regeneration.


A problem is, that the nerve at that level of the finger is pretty small, and it trifurcates (splits into three branches) at the level of the distal interphalangeal joint (DIPJ) (the furthest joint out).

Usually, when a digital nerve is injured, it is recommended that it be repaired. Not necessarily to get the sensation to come back, though that is what the hand surgeon will tell you is the reason, it is mostly so the nerve will not form a neuroma. Repaired nerves do regain some sensation, but it is rarely normal, though it is protective. At the level of the DIPJ, it MAY be possible to repair the digital nerve, if it has not trifurcated yet. But, the neuroma may be able to be taken out. This will require the use of the surgical microscope.


If the finger is really bothering you, then you should see a Hand Surgeon, trained in microvascular surgery.

Good luck.
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