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Hand Fractures

Personalized care for your hands

Hand fractures

A hand fracture is a break in one of the bones in the hand. This includes the small bones of the fingers (phalanges) and the long bones within the palm (metacarpals).

Hand fractures are crack or break in the bone itself. Damaging a bone in the hand will almost always shift it out of place. This will pull on the soft tissues surrounding other bones, which will result in misalignment of multiple joints, creating painful and inconvenient symptoms. Fractured bones may also put abnormal pressure on the soft tissues, leading to inflammation.

Hands have delicate musculoskeletal structures that must be treated urgently when injured to avoid stiffness and pain that make everyday activities difficult. We rely on the perfectly aligned bones and tissues in our hands to perform necessary tasks, like writing with a pen or buttoning a coat.

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Signs and symptoms of hand fractures

Hand fractures typically cause pain and swelling. Symptoms may be difficult to detect visually, but there is usually mild to severe pain. Whether it occurs in the phalanges or metacarpals, Hand fractures will make it difficult to bend the fingers or grip an object.

More symptoms of hand fractures include:

Pain increasing upon movement
Bruising of the area
Obvious deformities such as a shortened finger, a depressed knuckle, or a finger that crosses over the other fingers when attempting to make a fist
Swelling and tenderness
Numbness/ tingling when severe swelling leads to nerve impingement

Causes of Hand fractures

Hand fractures occur in athletes much more commonly than non-athletes. Hand damage is usually done during a fall or during contact sports.

Common sports-related Hand fractures are “boxer’s fracture.” Boxers often damage their fifth metacarpal, the bone of the outermost part of the hand, which is vulnerable to forceful impact when making a fist.

Motor vehicle crashes can cause wrist or hand bones to break, sometimes into many pieces, and often require surgical repair.

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Self care of hand fractures at home

You may have pain and swelling for 1 or 2 weeks. To reduce this, apply an ice pack to the injured area of your hand. To prevent skin injury from the coldness of the ice, wrap the ice pack in a clean cloth before applying and keep your hand raised above your heart.

For pain, you can take ibuprofen, naproxen aspirin, or acetaminophen, but do not give aspirin to children.

Follow the instructions about your splint that your doctor gave you. Your doctor will tell you when you can:

Start moving your fingers around more while wearing your splint
Remove your splint to take a shower or bath
Remove your splint and use your hand

Keep your splint or cast dry. For example, when you shower, wrap the splint or cast in a plastic bag.

Diagnosis of hand fractures

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Your physician will be able to diagnose a hand fracture through physical examination.

The orthopedic hand doctor will check for nerve damage and impaired blood flow to the hand first. X-rays will be used initially to provide a quick image of the disrupted bone structure.

A CT (computerized tomography) scan or MRI (magnetic resonance imaging) will create a more detailed image of the bones and soft tissues that have undergone damage along with the fracture.

Imaging tests help the orthopedic hand doctor determine the best treatment options for their patients.

By examining the severity of misalignment and tissue damage, an orthopedic hand doctor can decide whether or not surgery is necessary to fix the hand fracture, or if immediate immobilization followed by physical therapy will be sufficient.

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Treatment of hand fractures at NSOC

If a fracture does not line up in an acceptable position, often, your doctor can realign the bone fragments by gently manipulating them back into position without making an incision. This procedure is called a closed reduction.

A cast, splint or brace may be applied to keep the bones in acceptable alignment while they heal. The cast may extend from your fingertips almost to your elbow to support the bones properly.

Depending on the location and stability of the fracture, you may have to wear the cast for 3 to 6 weeks. Some types of fractures can be protected by wearing a removable splint or by being “buddy strapped” to an adjacent non-injured finger. The non-injured finger acts as a “moving splint” to support the injured finger.

When the cast or splint is removed, physical therapy should begin. Physical therapists in Nairobi, Kenya at NSOC will begin recovery of your hand fracture by slowly stretching the soft tissues in the area to reduce stiffness.

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When is surgery needed?

In more traumatic instances, a hand fracture could require surgery to save the shape and functionality of your hand. These cases cause more tissue damage, and tissues are not so easily repaired as bone. This is usually necessary when:

There are multiple fractures or bones have shattered, as is common in motor vehicle accidents
A bone is knocked severely out of place
A fracture extends to a joint in the hand
A loose fragment from a fracture is loose within a joint making the entire hand extremely unstable

There are various ways in which your orthopedic hand surgeon will repair a hand fracture. In many cases, wires, screws, or plates will be used to hold fractured bone together until they heal. These implants may even remain in the hand after healing to provide extra support in the future.

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