Our hands are incredibly important to everyday life. Activities as simple as picking up a pencil, driving a car, or holding a bag of groceries are all made possible by the complex network of bones, muscles, and tendons that work together in the hand and wrist.

Because we use our hands so often for many different daily tasks, they become susceptible to breaks. It’s important to consult a trained orthopaedic provider when injuries occur.

Fractures are when a bone breaks. Sometimes a fracture is called a broken bone. The words can be used interchangeably.

Types of Hand Fractures

The hand is made up of three types of bones: phalanges (in the fingers), metacarpal bones (in the middle hand and palm), and the carpel bones (in the wrist). Each of these are important for movement and strength of the hand. Several types of fractures can occur in these bones:

• Hairline fractures. These are usually the result of overuse, not an acute injury. Although they can often be painful, some are barely noticeable and nearly all can heal on their own with rest.
• Stable fractures. These occur when bones break but remain properly aligned.
• Unstable fractures. These occur when bones dislodge and shift from their natural alignment. The bone may also break and shatter into several pieces. These fractures often need surgery to heal properly.

Signs & Symptoms of a Fractured Hand

Hand fracture symptoms may include:

• Swelling
• Bruising
• Tenderness
• Pain
• Limited or no ability for movement
• Visible deformity (such as a displaced bone or skin puncture)
• Discoloration

If you have an injury, schedule an appointment with a hand provider. They will start with getting X-rays, which show us the bones.

The physical exam is an important part of the evaluation because sometimes an injury can involve the ligaments or muscles which are not visible on X-ray. On occasion, further imaging needs to be done to look at the tendons and ligaments, and an MRI is ordered. CT scans can also be done to further look at a significantly broken bone.

With high energy trauma such as motor vehicle accidents or high-impact falls, the bone may break and poke through the skin.

Open compound fractures, where bone pierces through the skin, require immediate treatment for both the fracture and possible infection. If you believe you have an open compound fracture, please visit an emergency room.

Treatment and Healing

After the provider reviews the X-rays and does a physical exam, treatment options will be discussed. Bones on average takes about 6 weeks to heal. To ensure proper healing, many broken bones are immobilized in either casts or splints. After immobilization, patients often have stiffness, and physical therapy can help regain range of motion and strengthening.

Sometimes broken bones need surgery to put the bone in a better position. Your provider will talk with you about the options after a full evaluation.

Casts

Casts and splints are often used to treat mild stable breaks. Casts are custom fit to your body to immobilize the break and support the bones as they heal. Immobilizing the break also helps reduce pain. Patients typically wear a cast for 3-6 weeks of recovery time.

Physical Therapy

Immobilization for several weeks can cause muscles in the hand to atrophy while bones heal. After a cast is removed, physical therapy is important for restoring stability, preventing complications, and managing pain.

Physical therapists will often prescribe a personalized series of exercises for patients to complete over several weeks. These movements often include weight bearing exercises and resistance training, which helps patients regain mobility and strength in the hand.

Surgery

For severe breaks that result in instability or displacement, surgery to insert metal pins, plates or screws may be necessary to set the bones. Ensuring they are in proper alignment during healing is vital to a healthy recovery.

Patients should seek immediate care if they suspect they are suffering from a broken hand, wrist, or finger. If left untreated, the fracture may not heal properly and cause limited function or physical deformity indefinitely.

Visit Campbell Clinic to speak to one of our board-certified hand surgeons today.