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Patient education: Hand fracture (The Basics)

Patient education: Hand fracture (The Basics)

What is a hand fracture? — A "fracture" is another word for a broken bone. The hand bones are also called the "metacarpals" (figure 1). There are different kinds of fractures, depending on which bone breaks and how it breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

If a broken bone sticks out of the skin or can be seen through a wound, doctors call it an "open" fracture. If the bone does not stick out of the skin or cannot be seen through a wound, doctors call it a "closed" fracture.

A "boxer's fracture" is a common type of hand fracture. With this fracture, a person breaks the bone between the little finger (pinky) and the wrist. Even though this fracture is called a boxer's fracture, it does not usually happen in experienced boxers. It more often happens when people punch a wall or other solid object, or are hit hard in the hand while their fist is closed.

Other types of hand fractures might be caused by something falling on the hand, a sports injury, or other accident.

What are the symptoms of a hand fracture? — Symptoms depend on which bone breaks and the type of break it is. Common symptoms can include:

Pain, swelling, or bruising over the area

The area looks abnormal, bent, or not the usual shape

A finger might look like it is bent in an abnormal position

Not being able to move the hand or fingers

Trouble making a fist or grasping things with the hand

Numbness in the area of the broken bone

Is there a test for a hand fracture? — Yes. Your doctor or nurse will ask about your symptoms, do an exam, and take an X-ray of your hand. They will also ask about how the injury happened.

They might do other imaging tests such as a CT, MRI, or ultrasound. Imaging tests create pictures of the inside of the body.

How are hand fractures treated? — Treatment depends, in part, on the type of fracture and how serious it is. The goal is to have the ends of the bones line up with each other so the bone can heal.

If the ends of the bones are already in line with each other, the doctor will put a splint, brace, or cast on your hand and wrist. This keeps the bone in the correct position so it can heal.

If the ends of the broken bone are not in line with each other, the doctor will need to line them up:

Sometimes, they can move the bone to the correct position without doing surgery, and then put a cast, splint, or brace on. This is called "closed fracture reduction."

For more serious fractures, they might need to do surgery to put the bone back in the correct position. This is called "open fracture reduction." During surgery, the doctor might:

Use screws, pins, rods, or plates to hold the bone in place inside your hand.

Put pins or screws through the skin and into the bones, and then attach the pins or screws to a bar that is outside of the skin.

If there is an open cut with the fracture, the doctor will wash the cut well. The doctor might also suggest a tetanus shot, based on when you had your last one.

How long do hand fractures take to heal? — Most hand fractures take weeks to months to heal. The doctor or nurse will talk to you about when to return to things like work, sports, or other activities.

Healing time also depends on the person. Healthy children usually heal much more quickly than older adults or adults with other medical problems.

How do I care for myself at home? — To care for yourself or your child at home:

Follow the doctor's instructions for wearing the splint, brace, or cast. This supports and protects the bone as it heals. Some fractures are placed in a cast right away. Other fractures are not put in a cast until after the swelling goes down. You might also get a sling to support your arm and hand.

Do not get a cast wet unless the doctor says that it is waterproof.

Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do.

Prop your injured hand on pillows, keeping it above the level of your heart. This might help lessen pain and swelling.

The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

Some people get a prescription for stronger pain medicines to take for a short time. Follow the instructions for taking these medicines.

Ice can help with pain and swelling:

Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

Use the ice (or other cold object) for at least 6 hours after the injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 2).

If you smoke, try to quit. Broken bones take longer to heal if you smoke.

Some people need to work with a physical therapist (exercise expert) after their fracture heals. The physical therapist will suggest exercises and stretches to strengthen your hand and finger muscles and keep them from getting stiff.

When should I call the doctor? — Call for advice if:

There is less feeling or movement in the fingers.

The hand or wrist becomes swollen or starts to hurt more.

The skin becomes red or irritated around the cast, or the redness starts to spread up the arm.

The splint or cast feels too tight and uncomfortable, or the fingers turn pale, blue, or gray.

There is a bad smell or drainage coming from the wound, splint, or cast.

The cast feels too loose, you notice a crack in the cast, or the cast becomes soft.

The cast gets wet, and it is not supposed to get wet.

More on this topic

Patient education: Fractures (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)
Patient education: Quitting smoking (The Basics)

Patient education: Quitting smoking (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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