What is a Hand Fracture?
Hand fractures can occur in the small (phalanges) or long (metacarpals) bones of the fingers, and are typically the result of a crush or twisting injury, fall, or strong, direct impact. There can be pain, swelling, tenderness, stiffness, or an inability to move the affected fingers, hand, and/or wrist, depressed knuckle, and even deformity (of the fingers affected) involved.
Your doctor will first perform an examination to obtain a basic understanding of the condition of your fingers and hand, including range of motion tests. X-rays are then taken to obtain additional information about the location of the fracture(s).
Types of Fractures
There are different types of fractures which determine the severity of the injury, such as:
- Stable: where the bones are still aligned;
- Unstable: where the bone fragments have been displaced or shifted;
- Comminuted: where the bone(s) have been shattered; or
- Open (or compound): where the bone has broken through the skin.
Treatment, Rehabilitation, and Recovery
Hand fractures can typically be treated without surgery by the use of a splint, cast, or fracture-brace for three to six weeks, extending from the fingers to the elbow in order to hold the bones in place. If the fracture is unstable, the bone will first need to be set and held in place with pins or wires. Follow-up x-rays are also typically necessary in order to assess whether and how the bones have healed in place.
However, any hand fractures that involve bone(s) breaking through the skin, and sometimes when the bone has shattered into many pieces, can require surgery and the use of screws, plates, or wires in order to hold the fractured bones in place. It is crucial that the bone does not change position while healing, or you can lose some function in the affected finger(s), and a bone graft may be necessary in cases where the bone is missing or cannot be repaired.
Your doctor will often instruct you to engage in rehabilitative exercises around three weeks after your cast has been put on. Most people are eventually able to regain full use and motion of the hand and fingers, even if the affected finger(s) are slightly shorter in length as a result of the injury. Physical therapy can also help restore strength and range of motion in the event of joint stiffness.
Some of the issues that can develop during the healing process include:
- A fracture callus;
- Problems with healing; and/or
- Shifting of the bone(s).
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