Hand Fracture

What is a hand fracture?

A hand fracture is a break in one of the bones in your hand. Your hand is made up of bones called phalanges and metacarpals. Phalanges are bones of the fingers. Metacarpals are bones that make up your knuckles and connect to your wrist.

What causes a hand fracture?

A hand fracture is often cause by an injury. Car and sports accidents are common causes. A fall on your hand or a direct blow caused by sports, such as boxing, may cause a hand fracture. Stress fractures may happen from repetitive or overuse. Softball and tennis are common causes of stress fractures.

What are the different types of hand fractures?

  • Nondisplaced: The bone cracks or breaks but stays in place.

  • Displaced: The bone breaks into 2 pieces.

  • Comminuted: The bone is broken in many different places.

  • Open fracture: The broken bone breaks through your skin.

What are the signs and symptoms of a hand fracture?

  • Pain that gets worse when you move your hand or wrist

  • Problems or pain when you try to grab or hold an object

  • Swelling, bruising, or open breaks in the skin of your injured hand

  • Tenderness over the injured area

  • Problems moving your injured hand

  • Abnormal bump or your hand is shaped different than normal

  • Weakness or numbness in your hand

How is a hand fracture diagnosed?

Your caregiver will examine your hand and wrist. He may touch your hand to see if you have decreased feeling. He will look for any open breaks in the skin of your injured hand. He also may check to see if you can move your hand. You may need any of the following:

  • X-rays: These are pictures of your hand to check for broken bones.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your hand. The pictures may show a fracture or other hand injuries. You may be given dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your hand. An MRI may show a fracture or other hand injuries. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

  • Bone scan: You are given a small, safe amount of radioactive dye in an IV. Pictures are then taken of your injured hand. Caregivers can look at the pictures for broken bones.

How is a hand fracture treated?

  • Brace, cast, or splint: A brace, cast, or splint may be used to decrease your hand movement. These work to hold the broken bones in place, decrease pain, and prevent further damage to your hand.

  • Finger strapping: If you have a broken finger, your broken finger may be strapped or taped to the finger next to it. This can provide support, limit motion, and decrease stiffness.

  • Medicine:

    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Tetanus shot: This is a shot of medicine to prevent you from getting tetanus. You may need this if you have breaks in your skin from your injury. You should have a tetanus shot if you have not had one in the past 5 to 10 years.

  • Surgery: If you have an open fracture, you may need debridement before your surgery. This 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: In this surgery, 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 holds your bones together so they can heal. It is often done if you have severe tissue damage or many injuries.

    • Open reduction and internal fixation: Your caregiver will make an incision 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 bones to grow back together.

    • Pin fixation: With this surgery, metal pins will be used 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.

What are the risks of a hand fracture?

  • You may have numbness or weakness in your hand from surgery. After surgery, you may have pain, tightness, or your hand may not 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 an infection. You may get a blood clot in your arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.

  • 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.

What can I do to help my hand heal?

  • Rest: You may need to rest your hand and avoid activities that cause pain.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your hand for 15 to 20 minutes every hour as directed.

  • Elevate your hand: Raise your hand above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your hand on pillows or blankets to keep it elevated comfortably.

  • Physical therapy: A physical therapist teaches you exercises to help improve movement and strength and to decrease pain.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • You have new sores around 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 questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • The pain in your injured hand gets worse, even after you rest and take pain 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, white, or blue.

  • Your cast cracks or gets damaged.

  • Your arm feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and short of breath.

  • You have chest pain when you take a deep breath or cough. You may cough up blood.

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. 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.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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