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.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• If you need a brace, cast, or splint, your hand may become very stiff. During surgery, the nerves, tissues, and blood vessels in your hand may be damaged. You may have numbness or weakness in your hand. You may form scar tissue near your surgery site leading to tightness and pain in your hand. After surgery, you may get an infection. You may also get an infection where pins have been placed through your skin. Your hand may not heal, or work as well as it did before your injury. Screws, nails, or pins used during your surgery may come loose, and you may need another surgery.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• Without treatment, your broken hand may not heal. If your fracture heals on its own, your hand may be deformed. You may not be able to move your hand as well as you did before your injury. You may have pain and weakness in your hand. You also may lose feeling in your hand. You may have tissue damage, and you may get an infection. Ask your caregiver if you have any questions or concerns about your hand fracture or treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Tetanus shot: You may need a tetanus shot if you have breaks in your skin from your injury. A tetanus shot is a shot of medicine to prevent you from getting tetanus. The shot is normally given into your arm. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.

Treatment options:

Treatment depends on which bone in your hand was broken, and what kind of fracture you have. You may need any of the following treatments:

• Brace, cast, or splint: A brace, cast, or splint may be put on your hand to decrease your hand movement. Braces, casts, and splints work to hold the broken bones in place. These devices may help decrease pain, and prevent further damage to your broken bones.
  
  
• Finger strapping: Your caregiver may strap your broken finger to the one next to it. Strapping your broken finger will hold the broken bone in place. Strapping the broken finger to a non-broken finger allows the fingers to move together to decrease stiffness.
  
  
• Surgery: If you have an open fracture, you may need debridement before your surgery. Debridement is when your caregiver removes damaged and infected tissue, and cleans your wound. Debridement is done to help prevent infection and improve healing.
  
  
  • External fixation: During external fixation, screws may be put through your skin and into your broken bones. The screws will be secured to a device outside of your hand. External fixation will allow your bones to be held together so they can heal. External fixation is often done if you have severe tissue damage, or you have many injuries.
    
    
  • Open reduction and internal fixation: During internal fixation surgery, your caregiver will make an incision (cut) in your hand to straighten your broken bones. He will use screws and a metal plate, nails, or wires to hold your broken bones together. This surgery will allow your broken bones to grow back together.
    
    
  • Percutaneous pin fixation: During percutaneous pin fixation, your caregiver will use metal wire pins to straighten the broken bones in your hand. The pins will hold the broken pieces of bone together. Your caregiver will place the pins through your skin and into your bone using a small drill.
    
    
  • Bone graft: A bone graft may be needed to replace lost bone from your fracture. A bone graft is a piece of bone taken from another area of your body. The bone graft may also be from a donor (another person). The graft is put into spaces between or around the broken bones in your hand. This surgery may help your bones heal and keep their strength.
    
    
    • X-ray: After surgery, an x-ray picture of your hand will be done. The x-ray is done to check if the bones in your hand are being held together properly.
      
      

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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.

Learn more about Hand Fracture (Inpatient Care)