Long story short, I had a crush injury to my hand last fall and have pretty much re-written the book on complications since. I am now facing the possibility of having to amputate my index finger and corresponding metacarpal. Since I am an eventer, I am hoping to find others in the sport with a similar challenge and how you adapted. What were your struggles and successes? Did you find any special reins or other devices that helped?
Thank you!
Not exactly the same, but I know a guy who lost his thumb after a cow-roping accident. He gave up that but switched to cutting horses and was top ten in the country. No problems with that or anything else. He did tell me that he gave all the credit to an excellent PT person. So if you need to go through this, find the best PT person you can, take reins (bit attached) with you and see what they say when you announce that you must be able to ride! (said somewhat in jest, but not entirelyâŠ)
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Find the best Certified Hand Therapist in your area. This will usually be an Occupational Therapist, but may be a PT.
An OT will be more focused on whatever function is is you want to have afterwards. If you go in with Riding as a goal, an OT will do everything in their power to get you there, adaptations included. This is where we are a bit diferent than PT, who focus mainly on the physical functioning.
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I canât offer insight about post-amputation outcome, but have you gotten a 2nd or 3rd opinion? A close relative of mine pioneered limb re-attachment surgery, as well as saving limbs that were once routinely amputated years ago. While there are many situations where crush, burn or other horrific injury to limbs cannot be saved, there are many that can. The Kleinert Kutz Hand Center in Lousiville, KY specializes in hand injuries. I personally know 2 people who were told their fingers were too mangled to be saved after acute injuries. My relative performed the surgery that saved their fingers after they traveled across country to get his opinion. I also personally know a teen boy who badly injured 3 fingers holding a large firecracker too long. This facility was only able to save 1 finger, but better than losing all 3, which was recommended by a local trauma center.
I did break my index finger about 10 years ago and couldnât use it normally for 6+ weeks. I held the rein with my thumb and middle index finger knuckle. It wasnât a terrible adjustment, although I had the comfort of knowing it was temporary.
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If the issue is your finger is too far damaged to be functional, amputation is best as is poor blood flow to digit or recurrent infections. Basically your middle finger will do the work . I had a little finger that had 2 tendon surgeries and had scarred in a bent position. Amputaion was on the table but I found a good hand surgeon and my finger is great and fully functional.
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That sounds like such a tough year youâve gone through. I hope youâre holding up ok and have good support around you.
In terms of useful things - Iâll be following this with interest! I want some nice fairly wide squishy reins with stoppers I think. Iâve seen reins with loops sewn in - could be worth a look?
As others have already asked - are you seeing the best possible surgeon you can?
Iâm one week post surgery on the middle finger of my right hand, after having the tendon fully ripped off the PIP joint back in April. Itâs been successful stage 1, Iâll need stage 2 in 4-6mths. Final outcome - uncertain - Iâm hoping for decent functionality and no pain. As my physio said - thank goodness Iâm not a musician!
Honestly it has been a hell of a thing. It seemed like such a little thing on the day of the injury - it didnât even hurt that much! I had to switch physios and had to switch surgeons when the first one had very poor options - either fuse the joint (so annoyingly useless but no longer painful), attempt external fixation (risky & low chance of success), or amputation (um, no?). I was able to get to a really good hand surgeon in another city who was rather horrified by those options - but he did say it wasnât going to be straightforward. I nearly cried just before surgery when he said that it was a desperate situation. He was a lot more positive post surgery - but still very guarded in the prognosis. I think itâll be a year in total before itâs âfinishedâ.
FWIW riding with a middle finger that was stuck half bent and couldnât open or close wasnât a problem at all in terms of rein handling. I rode right up to the op with my finger in a splint - including show jumping and going hunting 
I did stop jumping after mashing it on my horseâs neck when he chipped in over a cross rail and the pain was excruciating. Iâll probably sneak back on him in a few weeks as I trust him and can ride with one hand safely. No plans to ride my younger horse for a while.
Good luck - I hope you get as good an outcome as possible
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I can not comment on a total amputation.
The index finger on my non-dominant hand was injured (amputation) and is now shorter than it was originally. I spent enough time with it healing that I continue to do most index finger tasks with my middle finger now that everything is healed.
I think if you do have to have it totally removed, with a good hand PT you will quickly learn to ride using your middle finger in its place.
Be sure that your PT/OT specializes in hands. Before my injury I never knew that was even a thing⊠but it is and it is worth finding one to help you on your journey thru this.
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Not me, and not an index finger, but Richard Jones lost his ring finger and rode around Burghley 11 weeks later. He still competes successfully today!
Some discussion of his modifications and the injury here: https://secure.horseandhound.co.uk/features/tales-burghley-richard-jones-rider-defied-odds-compete-630928
Thank you! I will look into this hand center. Louisville isnât that close, but is doable! I have a second opinion appt. scheduled for Tuesday. I have been given a couple of âfixâ option, but they are not great and the prognosis is not necessarily what I would want it to be to go through so many more surgeries. I have already had a bone graft done and the titanium plate that was holding the graft in place broke in half and the graft did not take because of it. I am 4 surgeries in already and have some use of my hand, but no where near 100%. I know it will never be 100% again, but I would like to have more than I have now!
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Thank you and I hope you are back to 100% soon as well! Look at the âcorrect connectâ website. I just ordered a pair of reins from them that have squishy hand holds. Of course they are back ordered, but hopefully the wait wonât be too long. I have been seeing an excellent surgeon that specializes in hands and have an appt. for a 2nd opinion next week with another specialist. This has been a very long road already! I am very lucky that my husband, kids and parents are an amazing support system. I also have some amazing friends! I will let you know about the reins once I get them!
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I know someone with a nerve injury in her hand that makes it hard to close her fist tightly and she swears by the thinline reins. She says they are easier to grip and they give her better feedback which is important with the nerve damage. So maybe try those!
Gee, Iâm so sorry youâre having such a terrible time. Sounds just awful. The Kleinert Kutz center is one of the best in the world. Youâve been through so much, but if anyone could help you, I truly believe they could. Circulation and microvascular specialists could be the key to restoring your finger. In any event, I truly wish you the best of luck!! 
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Ooof, that sounds like itâs been one tough road for you - and much more complicated than mine. Iâm glad your family and friends have your back.
Iâll cross my fingers that still cross 
that the second opinion proves valuable - not all specialists are created equal. The first surgeon I saw was a hand specialist but I asked my doctor friends for the best and luckily was able to see one of the 3 recommended surgeons relatively quickly.
Thanks - they look interesting! Those and the thinline ones that @Turntableâs friend likes
Thank you so much! I have looked into this place and if we donât feel 100% confident after the second opinion appt. I have scheduled for tomorrow, my husband and I have decided to take a road trip to KY to see someone at this clinic.
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Thank you! I have been working with an OT that specializes in hands. She seems very determined to get me back as much function as possible. I also have limited mobility in my other 3 fingers. The hardest part is unless you ride, most people donât understand what we need our hands to do. I have taken in my reins to demonstrate, and shown her videos and pictures, but Iâm still not sure she fully understands. Most of the riding stuff I have had to figure out on my own.
Yes, I can understand that itâs difficult to grasp for a non rider. That said, itâs technically her job and in her mandate to address your occupations (from dressing, to cleaning the house, to what you do for leisure). If she can only go so far addressing where you are at, maybe itâs time to see if she can help you find an OT that rides? We exist! You could always keep who you have for hand therapy, and find another for a consult or two for riding specific questions.
If that route doesnât work, if you have any Therapeutic Riding centres in your area, they may have some ideas. They often work with people with low tone or difficulty holding reins and may have some already tried solutions? Iâm grasping here, but you never know! You certainly arenât the only person in this situation.
I would also look into Correct Connect reins as a tool you could utilize.
Thank you! I actually have a pair on order from them already. Unfortunately, they are back ordered, but hopefully will be available soon!
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Wherever you go, check to make sure your orthopedist is a member of the Hand Society (American Society for Surgery of the Hand .)
They have a link to check for finding a surgeon near you
https://www.assh.org/handcare/fahs
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