Hand and Finger Fractures

By Christopher D. Johnson, MD, FACS

A finger fracture (broken finger) may seem minor, but many factors need to be considered when dealing with these common injuries.  The small bones of the hand line up precisely, so any malalignment of these bones can cause pain, swelling and loss of function.  The symptoms of a broken finger are normally point tenderness, swelling, pain, decreased range of motion and/or deformity.

An x-ray is standard procedure and treatment for this injury generally involves realignment of the bone, splinting, ice, elevation, and buddy taping for support. Broken fingers can be quite complex depending on how the bone(s) break.  For certain fractures, there is a spiral component or shattered bones and surgical treatment is necessary.

Hand injuries are also very common in the athletic population.  These injuries generally result from a fall, a crush injury, a twisting injury or a direct blow.  Similar to a finger fracture, these injuries present with pain, swelling, bruising, loss of motion and point tenderness.  Treatment includes x-ray, motor and sensory tests and an evaluation of the range of motion.

Many injuries will heal after 4-6 weeks of immobilization in a cast or splint.  Other injuries, however, will require surgery.  Orthopaedic surgeons utilize plates, screws and/or pins to realign the bones.  It is also frequently recommended that these patients get occupational and/or physical therapy to restore movement because stiffness is the most common complication of treatment for these injuries.  It is of paramount importance to choose a treatment that limits stiffness.