Description
A hand fracture is break in one of the bones of the hand. Hand fractures most commonly occur when people attempt to brace themselves from falling by outstretching their hand. In most cases, a hand fracture will heal without surgical treatment.
Symptoms
- Pain
- Swelling
- Tenderness
- Deformity
- Shortened finger
- Depressed knuckle
- Crossed fingers when attempting to make a fist
- Weakened grip strength
Causes
- Forceful twisting or bending of the hand
- Falling on an outstretched hand
- Crushing trauma
- Direct blow (sports injury, auto accident, punching something)
Risk Factors
- Participation in sports that have an increased risk of falling, such as, football, soccer, rugby, snowboarding/skiing, ice and inline skating, ice hockey and horseback riding.
- Osteoporosis
Prevention
- Wearing safety or protective equipment properly when necessary (sports or hands on work)
- Avoid falls by being aware of surroundings and moving cautiously.
Diagnosis
- Your doctor will discuss your symptoms, review your medical history, and perform a thorough physical examination of your hand. During the physical examination, your physician will perform some range-of-motion tests along with an assessment of sensation in the fingers. This will determine if there has been any damage to the nerves.
- An X-ray will identify the type and severity of the fracture.
- CT scan: If a fracture is suspected but did not appear clearly on an x-ray, a CT scan can be performed. CT scans will also show surrounding soft tissues and blood vessels.
- MRI: A MRI can be performed to identify small fractures and associated ligament injuries.
Treatment
- In most cases, hand fractures will successfully heal with non-operative treatment methods. However, for more severe cases, surgery may be required.
- Realign fracture with manipulation
- Cast/splint/brace to immobilize the bones
- The healing process should be monitored with a series of x-rays to ensure that the bones have not shifted.
- NSAIDs
Physical therapy to restore range of motion and strength in the hand once the cast or splint is removed.
Goal
Proper realignment of hand bones.
Complications
- If the bones rotate during the healing process, then loss of function could result.
- Ongoing stiffness or aching
- Osteoarthritis
- Nerve or blood vessel damage
Outcomes/recovery
The cast will remain for approximately three to six weeks, depending on the severity and location of the fracture. If the fracture only requires a splint, gentle hand exercises usually begin after 3 weeks.
