I'm probably just being vain because I've lived 20 years with this problem and never did anything about it. But I have a very crooked middle finger from an old softball injury. Is it too late to do something to straighten it out. The tip is bent back and the middle knuckle is permanently bent.
It sounds like you may have a finger deformity referred to as Boutonniere's. Just as you describe, the tip of the finger is hyperextended and the middle joint is stuck in flexion. Some people can passively straighten the finger out (by using the other hand to pull the finger straight). But a permanent contracture (joint is stuck) may be present, in which case you can no longer change the position of the joints. Tightening of the extensor tendon from injury or scarring can lead to a permanently crooked finger. The boutonniere deformity affects the extensor tendon of the finger so it no longer works properly. The injured area of the tendon is called the central slip. Damage occurs where the extensor tendon attaches to the middle phalanx (bone) of the finger. By now, after 20 years, it's likely that the tendon has scarred down and is stuck in place (called a contracture). Even after all this time, the first consideration may still be for conservative (nonoperative) care with splinting, range-of-motion exercises, and strengthening exercises. Many hand surgeons will try six weeks of splinting with the spring-type splint and exercise to see if the deformity lessens to a tolerable limit before considering surgery. This is desirable before surgery to stretch out a joint contracture before repairing or reconstructing the extensor tendon. If it is just a matter of cosmetics (appearance), surgery may not help. If loss of motion has resulted in loss of function and disability, then surgery deserves a closer look. The surgeon can reattach the central slip and reconstruct the rest of the damaged soft tissue structures. Surgical procedures that can be used include lateral band reconstruction, central slip reattachment, central slip reconstruction, extensor tenotomy, or tendon and transverse retinacular reconstruction. Each of these procedures has its own advantages, disadvantages, and indications (when to use each one). Some patients may need more than one operation. This concept is referred to as staged reconstruction. Decisions around what surgery to do and when to do it focus on how long ago the injury occurred, how much capsular (joint) stiffness is present, and the severity of the extensor lag (finger doesn't straighten all the way). To satisfy your own concerns, it may be well worth your time and effort to seek out an opinion from a hand surgeon who can best advise you. Boutonniere deformities are notorious for not responding quickly or easily, so just go prepared for any possibility. Perhaps you'll be pleasantly surprised if splinting and exercise is all that's needed!