Hand & Wrist: Hand Fracture


A fractured bone is the same thing as a broken bone. A fracture occurs when force is applied to a bone causing it to break. 

The metacarpal bones connect the small wrist bones to the knuckles on the hand.

Causes of Hand Fractures

Fractures can occur from a fall, a crush injury, a twisting injury, or contact in sports. They can happen along the shaft of the bone or near the surface of a joint.

A simple fracture occurs when the pieces of bone are aligned and stable. Other types of fractures may be unstable and the pieces displace from one another. Comminuted fractures involve many small pieces and are usually unstable. An open, or compound fracture occurs when a bone fragment breaks through the skin. There is a higher risk of infection with an open fracture.




Signs and symptoms of an Hand Fracture may include:
  • Pain and tenderness
  • Mid-severe swelling
  • Decreased range of motion, loss of motion, or abnormal motion
  • Deformity - such as a shortened finger, crooked finger, or a depressed knuckle
Splint or Cast

A splint or cast is used when a fracture is not displaced or has been set (closed reduction) and is stable

Closed reduction internal fixation

Closed reduction internal fixation is used when the fracture is displaced and/or unstable. The fracture is set and then held in place with wires or pins. The type of surgery does not involve an incision. A cast or splint is often used in addition to this treatment.

Open reduction internal fixation

Open reduction internal fixation is used when a fracture is displaced or close to the surface of a joint. More precise alignment is needed to restore the joint surface as close to normal as possible.

Bone grafts

On occasion, a piece of bone may be missing or so severely damaged it can not be repaired. In these cases, a graft of bone from another part of the body or cadaver may be used to provide more stability.

Hand Therapy

Once your doctor has determined the healing bone is stable, you may be referred to a hand therapist to work on exercises to help restore your motion. Hand therapists also make custom splints on the recommendation of your doctor.

Hand Fractures Hand Fractures

Figure 1

Examples of fractures in fingers

Figure 2

Examples of plates, pins and screws used to join fractures while they heal
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Courtesy of American Society for Surgery of the Hand