Hand Fractures

Fractures

A hand fracture occurs when one or more of the bones of your hand break or shatter. Direct impact or falls can cause this damage. Common examples of hand fracture include boxer’s, distal radius, and scaphoid fracture.

If you play contact sports like boxing or rugby or have a disease that causes your bones to weaken and become more fragile (osteoporosis), you may be more prone to fracture bones of the hand.

In most situations, non-surgical therapy is sufficient to repair a hand fracture. This may entail wearing a splint, cast, or buddy tapes for a length of time, depending on the kind and location of the fracture. Surgery to realign the fragments of bone may be necessary for more severe fractures or fractures that do not line up appropriately.

Types of Hand Fractures

Fractures are generally classified as closed and open fractures. These terms describe whether the fracture communicates (open) or does not communicate (closed) with the external environment. Hand fractures can be further classified as unstable and intra-articular:

Unstable Fracture

An unstable fracture is one with an intrinsic propensity to become displaced after the involved bones have been reduced (realigned). They have a high chance of progressing and causing more damage.

Metacarpal fracture resulting in rotational deformity

Intra-articular Fractures

A break that spreads from the bone into a neighbouring joint is known as an intra-articular fracture. For example, a radial fracture describes a break that has extended from the distal portion of the radius (the bigger of the two forearm bones) into the wrist joint. Depending on the degree and type of the fracture, these injuries might be difficult to manage.

Arthritis due to an untreated fracture

Phalangeal Fracture

Phalangeal fractures are common hand injuries that affect the distal, middle, or proximal phalanx. Direct blows to the hand are the most common cause of phalangeal fractures. Splints are used to treat most phalangeal fractures, but unstable fractures may require surgery to avoid complications like stiffness and malunion.

Other more severe injuries, such as nail bed tears or tendon lacerations, can accompany phalangeal fractures. In those cases, the focus of treatment is on soft tissue injury.

Hand Fracture/Broken hand symptoms

The following are signs and symptoms of a hand fracture:

Pain
Sensitivity to even the slightest contact
Numbness of the hand and wrist
Swelling
Redness
Deformity
Decreased range of motion

The patient's knuckle may appear depressed in boxer's fracture. The displacement or angulation of the “head” of the metacarpal bone causes this deformity.

Diagnosing Hand Fractures

Diagnosis of this condition starts from a clinical history and physical examination and may require laboratory or radiological tests for confirmation.

History and Physical Examination

Your doctor will inquire about your symptoms and examine your fingers and hand thoroughly. During the examination, they will check for the following:

Skin lacerations and cuts
Soft tissue swelling or bruising
Hand and wrist deformity
Involuntary overlapping of fingers

Usually, your doctor will examine the tendons in your hand to confirm that they are in good working order, as well as the joint(s) surrounding the fracture for signs of instability.

Radiological Test

X-rays are used to see dense internal structures such as bone. Hand surgeons may request one or more x-rays to determine the fracture's location, type, and extent.

Treatment of Hand Fractures

Hand fracture treatment can be surgical or non-surgical.

Surgical

Some patients may require an incision for realignment (open reduction) and the use of screws, rods, and plates (fixation) by orthopaedic surgeons to keep their bones in place while they recover. This is only possible with surgical intervention. Indications for surgery include:

Open fractures
Intra-articular fractures
Rotational deformity higher than 10 degrees
Angulation of the fracture larger than 30 degrees
Bone graft
Extensive (>5mm) shortening of the metacarpal bones

Non-Surgical

If a fracture aligns in an appropriate position, your hand doctor may typically realign the bone pieces without requiring an incision by gently moving them back into place. This method is known as a closed reduction. To keep the bones in proper position while recovering, patients may need to wear a brace, splint or cast. The cast may stretch from fingertips almost to your elbow to adequately support the bones. About 1 to 2 weeks later, your doctor will most likely request a second series of plain radiographs. This is done to confirm that the broken bone is undergoing the healing process in the proper position. You would have to spend 3 to 6 weeks wearing a cast, depending on the location and severity of the fracture. Wearing a detachable splint or being "buddy strapped" to a nearby non-injured finger can be beneficial in some types of hand injuries. The damaged finger is supported by the unaffected finger, which functions as a "moving splint." After three weeks, patients can commence hand therapy in the form of gentle exercises.

Hand Fracture Risk Factors

Fracture of the bones of the hand is more likely if you engage in contact sports or high-impact activities. Hockey, horseback riding, rugby, football, skating, skiing, and skateboarding are high-risk sports. Although it is hard to prevent fractures, you may do your best to preserve your bones by completing strengthening exercises, using wrist guards, and avoiding circumstances that could lead to a fall, such as running on slippery floors. Older age is also associated with hand and wrist fractures. Our bones deteriorate over time as part of the normal ageing process, making us more prone to fractures and other injuries.

Hand Fracture Recovery Process

During recovery, a bony lump is known as a "fracture callus" may develop at the site of the shattered bone. This is typical, and the lump will generally shrink and disappear with time. As you go through the healing process, you could experience the following issues:

Stiffness
Bones shifting
Infection
Delayed healing.

Avoid smoking and adhere to your doctor's advice to improve your chances of a healthy recovery. It's vital to keep in mind that not all fractures heal fully. The hand may remain stiff and feeble even after recovery because bones, tendons, and ligaments have such a strong link.

Hand Fracture Complications

A fractured hand's complications are uncommon, although they might include: Persistent pain, stiffness, or functional impairment: Once your splint or cast is removed following surgery, pain, stiffness, or discomfort in the area usually goes away eventually. However, some persons may experience chronic pain or stiffness. Give the healing process time and seek advice from your doctor about possible hand therapy. Osteoarthritis: Fractures that involve a joint might lead to arthritis in the long run. Consult your surgeon if the hand continues to ache or swell after you've taken a break. Damage to the nerves or blood vessels: Injury to the hand can cause damage to nearby nerves and blood vessels. If you experience numbness or poor circulation, get medical help right away. Poor growth: Fractures in children could occasionally affect the future growth of the affected bone(s).

FAQ

How do I know if I have a hand fracture?
These signs and symptoms can indicate a fractured hand:

Pain
Tenderness
Swelling and,
Deformity

When grasping, squeezing, or moving your hand

When to seek medical help for a Hand Fracture?
You should visit a doctor right away if you suspect you have a fractured hand. This is even more urgent if you experience numbness, swelling, or problems moving your fingers. A delay in diagnosis and treatment can result in poor healing, diminished range of motion, and reduced grip strength.

How to prevent Hand Fracture?
The majority of fractures are caused by unforeseen occurrences such as falls, blows, and car accidents. There are, however, certain steps you may take to decrease your chance of breaking a bone, they include:

To keep your bones strong, eat a nutritious diet rich in vitamin D and calcium.
Strengthen bones with weight-bearing workouts.
Avoid all forms of tobacco and nicotine.
Consult your doctor about your chances of developing osteoporosis. If you have it, seek treatment.

For immediate medical treatment, please contact our 24hr hand and wrist emergency hotline at +65 6535 8833.