Hand and Wrist

Hand Fracture

Description

A fracture of the hand can occur in either the small bones of the fingers (phalanges) or in the long bones (metacarpals).

Causes

A hand fracture can be the result of a twisting injury, a fall, a crush injury, or direct contact in sports.

Symptoms

Symptoms of a broken bone in the hand include: pain; swelling, tenderness; an appearance of deformity; inability to move a finger; shortened finger; a finger crossing over its neighbor when you make a fist; or a depressed knuckle, which is often seen in a "boxer's fracture."

Diagnosis

If you believe your hand may be fractured, have it examined right away. Your physician will assess the injury by checking the position of the fingers and condition of the skin, performing range-of-motion tests, and evaluating feeling in the fingers to ensure there is no damage to nerves. An X-ray can be used to identify the location and extent of the fracture.

Nonsurgical Treatment

Usually, the fracture can be realigned without surgery, using manipulation. A cast, splint or fracture-brace is then applied to immobilize the bones and hold them in place. A cast typically begins at the fingertips and extends past the wrist, almost to the elbow and will be worn for approximately three to six weeks. Gentle hand exercises may be recommended after three weeks. Additional X-rays may be needed to ensure that the fractured bones remain in position and are healing properly.

Surgical Treatment

For some fractures, particularly those that break through the skin (open or compound fracture) or result from a crushing accident, surgery is sometimes required to stabilize and align the bones. Your orthopaedic surgeon can implant wires, screws, or plates in the broken bone to hold the pieces of the fractured bone firmly in place. During the healing process, your physician may want to examine your hand periodically to ensure that the joint does not tighten or contract. Once the bone has healed, the implants may be removed, or left in place, depending on your individual situation.

Outcomes

You may experience some joint stiffness due to the long immobilization period. Your physician may recommend physical therapy to help you restore strength and range of motion in your hand.