Hand Fracture

WHAT YOU SHOULD KNOW:

• A hand fracture is a break in one or more of the bones in your hand. The bones in your hand include the phalanges and metacarpals. The phalanges are the bones in your fingers. The metacarpals form your knuckles and connect your hand to your wrist. A broken hand is often caused by trauma, such as a fall, injury, or an accident. Fractures also can happen when the muscles attached to your hand are stressed. Muscle stress leading to a hand fracture is more common in softball and tennis players.
  
  
• You may have pain, swelling, or bruising in your injured hand. Your hand may look deformed (shaped different than normal). You may not be able to move your hand like you normally do. You may need an x-ray, bone scan, or computed tomography (CT) scan to diagnose your hand fracture. You may need a brace, cast, or splint to decrease your hand movement while it heals. Surgery also may be needed to put your broken bones back in their normal position. Having your hand fracture treated may decrease your symptoms such as pain and weakness. Treatment may allow you to return to the activities you enjoy, such as sports.

AFTER YOU LEAVE:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

• Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Pain medicine: You may need medicine to take away or decrease pain.
  
  
  • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
    
    
  • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Follow-up visit:

• Ask your caregiver when to return for a follow-up visit. You may need a follow-up visit to remove your cast, splint, or stitches from surgery. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.
  
  

Bathing with a cast or splint:

If you have a cast or splint, it is important not to get it wet. Before bathing, cover the cast or splint with a plastic bag. Tape the bag to your skin above the cast or splint to seal out the water. Keep your hand out of the water in case the bag leaks. Follow your caregiver's instructions about when it is okay to take a bath or shower.

Cast or splint care:

Follow these instructions if you have a cast or splint:

• Do not push down or lean on any part of the cast or splint because it may break.
  
  
• Check the skin around the cast or splint for redness or sores every day.
  
  
• Do not use a sharp or pointed object to scratch your skin under the cast or splint.

Driving:

You may not be able to drive yourself for up to two weeks after treatment for your hand fracture. You may need to wait for your pain to decrease so you can better control a motor vehicle. Ask your caregiver for instructions about when it is safe for you to drive.

Elevate your hand:

Use pillows to keep your hand above the level of your heart. This helps decrease swelling and pain, and improves blood flow. Keeping your hand elevated can also help the injury heal faster.

Exercise your hand:

It is important that you keep moving your hand and fingers. Movement helps prevent stiffness and tightness in your hand muscles and joints. Try to open and close your hand and fingers fully, and try to make a fist. Your caregiver may want you to go to a hand therapist. A hand therapist will help you with special exercises. These exercises help make the bones and muscles in your hand stronger. Do not start exercising your hand without talking to your caregiver first.

Ice:

Ice causes blood vessels to constrict (get small) which helps decrease swelling, pain, and redness. Put crushed ice in a plastic bag and cover it with a towel. Put this on your hand for 15 to 20 minutes every hour. Use the ice for as long as your caregiver says you should. Do not sleep with the ice pack on because you can get frostbite.

Pin care:

If you have pins that enter your broken bone through your skin, you will need to clean them daily. Cleaning the pins can help prevent an infection. Ask your caregiver for more information about pin care.

Returning to sport activities:

Your hand fracture may heal in about 4 to 6 weeks, but it can take months to regain hand strength. You may need to avoid sports that can re-injure your hand. Ask your caregiver when it will be safe for you to play sports again.

For more information:

Contact the following:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You have new sores around the area of your brace, cast, or splint.
  
  
• You have new, or worsening trouble moving your hand.
  
  
• You notice a bad smell coming from under your cast.
  
  
• You have chest pain or trouble breathing that is getting worse over time.
  
  
• You have questions or concerns about your injury, treatment, or care.

SEEK CARE IMMEDIATELY IF:

• The pain in your injured hand gets worse, even after rest and taking medicine.
  
  
• You have drainage from your surgery wounds or open skin areas.
  
  
• Your surgery wound or open skin areas become red, warm, and swollen.
  
  
• Your injured hand or fingers feel numb.
  
  
• The skin or fingers on your injured hand become swollen, cold, or turn white or blue.
  
  
• Your cast cracks or gets damaged.
  
  
• You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
  
  
• You suddenly feel lightheaded and have trouble breathing.
  
  
• Your arm feels warm, tender, and painful. It may look swollen and red.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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