By DANA SCARTON


The pinkie, the humble fifth finger, has long been viewed as a decorative accessory, something to extend daintily from a wine glass. So what would you lose if you didn’t have one?

“You’d lose 50 percent of your hand strength, easily,’’said Laurie Rogers, an occupational therapist who is a certified hand therapist at National Rehabilitation Hospital in Washington, D.C. She explained that while the index and middle fingers function, with the thumb, in pinching and grabbing - zipping zippers, buttoning buttons - the pinkie teams up with the ring finger to provide power.

I learned this last April, when I fell while jogging and broke the bone at the base of my right pinkie, a bone the width of a pencil. It snapped at the metacarpophalangeal, or MCP, joint, where the finger links with the hand.

Five months later, my finger would not bend unassisted. I could not make a fist, swing a tennis racket with control, or securely grasp a dumbbell.

My situation was hardly unique. Fractures of the small finger and its metacarpal - the bone that extends from the base of the finger into the hand - occur about twice as often as fractures to any other unit of finger and metacarpal.

“People think if they’re not in pain and they can move their finger, it’s not broken,’’said Dr.Scott G.Edwards, chief of hand and elbow surgery at Georgetown University Hospital in Washington, D.C.“That’s simply not true.’’

Repairs to a broken small finger can involve pins, screws and plates. Eight days after my fall, two pins were inserted through the MCP joint. The procedure, performed by Dr.Edwards as outpatient surgery, reattached my proximal phalanx and straightened my middle knuckle. A cast was applied from fingertips to elbow.

Twelve days later, the cast was removed and rehabilitation began.

“Hand therapists are the ones who make us look good,’’said Dr.Leon S.Benson, chief of hand surgery at Evanston Northwestern Healthcare in Illinois.“I’m in the office acting happy and upbeat, then I say to the patient,‘Now you will go down and see Mary Beth, the therapist, who will hurt you.’’’

I got to therapy quickly but was assigned a therapist who was too timid to manipulate my finger. By the time I located a replacement, my finger was rigid, and scarring appeared to be well under way.

Scar tissue is more prominent and problematic in fingers because there is virtually no muscle, and tendons sit directly on the bone. Accumulating scar tissue in the smallest finger is akin to“getting glue inside a watch,’’Dr.Benson said.

An M.R.I. scan of my finger, taken after the pins were removed, confirmed that scar tissue had immobilized the flexor tendons, which are palm-side tendons that enable fingers to fold into a fist. Besides not receiving effective therapy soon enough, genetics may have contributed, since some people form scar tissue more easily than others.

In October, I underwent flexor tenolysis, during which Dr.Edwards freed the tendons. The day after surgery, I started therapy. Earlier this month, I completed my treatment; my finger now bends with ease and my hand strength has returned.

And the humble pinkie has earned my respect.