A fracture of the hand is quite common. It means that one or more of the carpal bones or metacarpal bones is broken. The treatment is based on the location and type of fracture that is discovered.
Anatomy
A hand, viewed from the wrist, can be divided into three different groups:
- The carpal bones
- The metacarpals
- The phalanges
This article discusses the fractures of the first two groups. Broken phalanges usually require a different approach.
Causes
The cause of a fracture of the hand bones is usually the result of trauma. An accident or fight are examples of this.
Symptoms
Symptoms that may occur with a hand fracture are:
- Swelling of the hand
- Difficult or impossible to move finger(s).
- Pain or tenderness of the hand
- Deformity of the hand at the site of the fracture
- Shortened finger
- Fingers are positioned differently from each other
- Depressed knuckle
Diagnosis
After a standard history and physical examination, the doctor will have x-rays taken if a broken hand bone is suspected. These photos can be used to diagnose the location and type of fracture.
Complications
Complications that may occur if medical help is not sought or if the treatment is not effective:
- Stiffness of the hand and fingers
- Permanent deformity of the fingers
- Damage to the tendons and soft tissues of the hand and/or finger
- Movement problems of the hand and/or fingers
Therapy
Depending on the type of fracture and the degree of severity, different treatment options are available:
Plaster cast, splint or brace
One of these is used to fix the fracture and keep the legs still. If possible, the fingers should be moved regularly again as soon as possible (on doctor’s advice), otherwise the muscles and tendons will become too stiff. This can cause permanent damage to the mobility of the fingers. Most plaster casts remain in place for about three to four weeks to start with. The fracture is then reevaluated.
Operation
If the fracture(s) are too serious or unstable, surgery may be performed. In this operation, the bones are stitched back together in the right place using pins and screws. Sometimes the material is removed again after healing through a minor operation. After the operation, a plaster cast is applied and a control X-ray is taken to see if the operation was completely successful.
In both cases, additional treatment by a hand physiotherapist is recommended to prevent complications.