Digital Nerve Repairs
Date issued: November 2023
Review date: November 2025
Ref: C-554/JT/Occupational Therapy/Digital Nerve Repairs
PDF: Digital Nerve Repairs 2023.pdf[pdf] 474KB
What is a digital nerve?
There are 2 digital nerves in each of your fingers and thumb.
They are positioned one on each side of the finger on the palm side of the hand. These nerves pass messages to your brain about what you can feel. They tell you when something is hot, cold, sharp, blunt, hard, or soft. They also help you recognise objects by touch, without seeing it, for example feeling for keys in your pocket.
What happens when the digital nerve is injured?
When the nerve is injured, the most obvious thing you will notice is numbness.
If only one nerve is affected, the fingertip will be numb on one side, but not the other.
What happens during surgery (digital nerve repair)?
The nerve is like a tiny electric cable, with an outer tube and thousands of thin fibres running through it. The surgeon will repair the outer tube, but the tiny fibres inside will die off from the level of the cut to the fingertip. If the nerve is not repaired, it will not recover, and may form a very painful lump called a neuroma.
What happens following surgery (nerve recovery)?
Initially following surgery, the wound will heal and form a scar.
A few weeks after the nerve has been repaired, the tiny fibres will very slowly begin to regrow. It may take many months for the fibres to reach the fingertip, so the finger is likely to remain numb for quite some time after the operation. You may also experience some strange sensations in your hand, such as pins and needles, tingling or electric type shooting pains. All of these sensations are normal after a nerve repair.
Wound management following surgery
You should have a wound check 7 days following your surgery. You should arrange this with your GP surgery unless one has already been prearranged by trauma clinic elsewhere.
Signs and symptoms of infection to look out for
If the wound is swollen, red, or hot to touch, or has any discharge or a foul smell coming from it you may have an infection. In these cases, we advise you seek medical attention from either a walk-in centre or your GP, particularly if this is associated with you feeling unwell. Alternatively, you can contact the plastics trauma clinic at Derriford on 01752 432105.
Swelling post-surgery
Swelling is a normal response to injury and surgery but can cause pain and limit movement. To help reduce this:
Try to keep your hand elevated as much as possible, at least for the first 5 days.
Try to keep your fingers and thumb moving as much as you can, within the dressing.
The swelling may persist several months, this is a normal part of the healing process. You should keep your fingers elevated where possible and complete your exercises in this elevated position.
Scar massage and desensitisation
Once the wound has healed it is important to start touching and massaging the scar.
Firmly massage the scar with unperfumed moisturiser. Massage across the scar line in circular movements using deep and firm pressure. This ensures that the scar does not stick to the underlying surface and helps the structures under the skin to move freely, as well as helping the scar to soften and flatten.
Massage the scar 4 times a day for about 5 minutes.
If you are experiencing any scar sensitivity or abnormal sensations, scar massage is especially important and helpful.
Touching, tapping, and exposing the scar to different textures can help to normalise the sensation as the numbness recovers and should help to reduce any sensitivity.
Please note while you have a lack of sensation in your hand, you will need to be very careful when cooking and holding sharp objects not to burn or cut your fingers.
Exercise and function post-surgery
The digital nerves do not directly affect your movement and therefore should not affect your ability to use the affected finger in everyday activities.
If there are no other injuries (e.g., to a tendon) then you should recover your normal movement, however in the early stages you may be limited by discomfort from stitches and swelling.
To help you regain movement, the following exercises should be performed 4 times a day. Each movement 10 repetitions, holding each position for 10 seconds.
Please contact the plastics trauma clinic at Derriford on 01752 432105 if you have any concerns.
If you would like to access the exercise videos, please visit www.hep.video and type in the specific access code related to the exercise.
Passive Exercises
It is important to start with these exercises as they help to improve the stiffness in your hand and prepare your hand for active exercises.
Passive Flexion
Use other hand to push the individual joints of the affected finger.Access code:
Access code: Access code: Access code:
VVYZUYHRX VVC4S9XKB VVSXBUN85
Use other hand to push all fingers into palm of hand.
Access code: VVGS979QR
Passive Extension: Use other hand to push fingers straight/push fingers straight on a flat surface.
Access code: VVGS979QR
Active Tendon Gliding Exercises
What are tendon gliding exercises?
Tendon gliding exercises are specific exercises which promote the motion of tendons in the surrounding soft tissues. These exercises help to reduce the adhesion between tendons and surrounding tissues, including the underlying bone, while you are recovering from your injury.
These exercises also help to reduce swelling in your hand.
Flat Tabletop Movement
Bend the knuckle joints (base of your fingers) forward without bending any other joints of your fingers.
Straighten your fingers.
Hook Fist Movement
Hold your fingers straight.
Bend your fingers down only at the top joints and middle joints.
Straighten your fingers.
Straight Fist Movement
Bend the knuckle joints (base of your fingers) forward without bending any other joints of your fingers.
Then bend your fingers at the middle joints but keeping the tip of your fingers straight. Straighten your fingers.
Full Fist Movement
Make a fist with your hand without clenching it tight.
From Full Fist to Hook Fist
Make a fist with your hand without clenching it tight.
Straighten your fingers at the knuckle joints, follow by your middle joints and end joints.
Isolated Finger Exercises
Top joint of your finger
Place your other hand below the top joint of your finger so that the rest of finger is straight.
Bend the top joint of the finger under your own power
Straighten the finger.
Middle joint of your finger
Place your other hand below the middle joint of your finger.
Keep all other fingers straight.
Bend your finger at the middle joint only.
Straighten your finger.
When should I call for an appointment
You have a 3-month open appointment to be able to access the plastics team.
As discussed, it is normal to feel some discomfort as the wound heals and this can take several weeks. Changes in sensation are also normal and can take up to 6 months to recover.
However, you should contact for an appointment at any time:
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If you feel your pain or swelling is worsening
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If you feel your movement or function is worsening
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Or 4-6 weeks post-surgery:
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If you have pain that is persistent, and you rate this between 7–10 out of 10 with 0 being no pain and 10 being the maximum.
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If you have heightened sensation to light touch/course touch/vibration or deep pressure that is not the same as the unaffected side
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If you have not regained full range of movement of the affected finger and this is impacting on your ability to complete everyday activities.
Please contact the plastics trauma clinic at Derriford on 01752 432105
If we do not hear from you 3 months following your surgery date, we will assume that you no longer require any further intervention and will be discharged. If you have further problems with your hand after this date, please contact your GP practice.
