A hand fracture is a common condition treated at Hand Center of Louisiana. A painful injury, it can diminish your quality of life by making it difficult to perform daily activities and routine tasks. Understanding this common hand injury, including its causes, symptoms, and treatment, can help you decide if you need to see a hand surgeon for evaluation.
What Is A Fracture?
The hand is made up of many bones that form its supporting framework. This frame acts as a point of attachment for the muscles that make the wrist and fingers move. A fracture occurs when enough force is applied to a bone to break it. When this happens, there is pain, swelling, and decreased use of the injured part. Many people think that a fracture is different from a break, but they are the same. Fractures may be simple with the bone pieces aligned and stable. Other fractures are unstable and the bone fragments tend to displace or shift. Some fractures occur in the shaft (main body) of the bone, others break the joint surface. Comminuted fractures (bone is shattered into many pieces) usually occur from a high energy force and are often unstable. An open (compound) fracture occurs when a bone fragment breaks through the skin. There is some risk of infection with compound fractures.
How A Fracture Affects The Hand
Fractures often take place in the hand. A fracture may cause pain, stiffness, and loss of movement. Some fractures will cause an obvious deformity, such as a crooked finger, but many fractures do not. Because of the close relationship of bones to ligaments and tendons, the hand may be stiff and weak after the fracture heals. Fractures that injure joint surfaces may lead to early arthritis in those joints.
Broken Hand Symptoms
A broken hand may cause one or more of the following symptoms:
- Severe pain that may worsen with hand movement, squeezing, and/or gripping
- Obvious deformity (e.g., crooked finger)
- Stiffness, decreased range of motion
- Immobility of fingers or thumb
- Numbness in hand or fingers
How Fractures Are Diagnosed
To diagnose a hand fracture, your hand surgeon will typically perform a physical exam of the appropriate hand and order an X-ray.
How Hand Fractures Are Treated
Medical evaluation and X-rays are usually needed so that your doctor can tell if there is a fracture and to help determine the treatment. Depending upon the type of fracture, your hand surgeon may recommend one or more options for your treatment plan. These options include:
- Splint or Cast
- Medication Therapy
- Physical Therapy
Splint or Cast
A splint or cast may be used to treat a fracture that is not displaced, or to protect a fracture that has been set. Some displaced fractures may need to be set and then held in place with wires or pins without making an incision. This is called closed reduction and internal fixation, respectively.
For pain management, your hand surgeon may recommend an over-the-counter (OTC) pain reliever, such as a non-steroidal anti-inflammatory drug (NSAID). In severe cases, your physician may prescribe an opioid medication, such as codeine, for your pain management.
Hand Fracture Surgery
Other fractures may need orthopaedic surgery to set the bone (open reduction). Once the bone fragments are set, they are held together with pins, plates, or screws. Fractures that disrupt the joint surface (articular fractures) usually need to be set more precisely to restore the joint surface as smooth as possible. On occasion, bone may be missing or be so severely crushed that it cannot be repaired. In such cases, a bone graft may be necessary. In this surgery procedure, bone is taken from another part of the body to help provide more stability. Sometimes bone graft substitutes may be used instead of taking bone from another part of the body.
Fractures that have been set may be held in place by an “external fixator,” a set of metal bars outside the body attached to pins which are placed in the bone above and below the fracture site, in effect keeping it in traction until the bone heals.
Once the fracture has enough stability, motion exercises may be started to try to avoid stiffness. Your hand surgeon can determine when the fracture is sufficiently stable.
What’s The Prognosis for Hand Fracture Surgery?
When fractures require surgery, perfect alignment of the bone on X-ray is not always necessary to get good function. A bony lump may appear at the fracture site as the bone heals and is known as a “fracture callus.” This functions as a “spot weld.” This is a normal healing process and the lump usually gets smaller over time. Problems with fracture healing include stiffness, shift in position, infection, slow healing, or complete failure to heal. Smoking has been shown to slow fracture healing. Fractures in children occasionally affect future growth of that bone. You can lessen the chances of complication by carefully following your hand surgeon’s advice during the healing process and before returning to work or sports activities. A hand therapy program with splints and exercises may be recommended by your physician to speed and improve the recovery process.
Repair Your Hand Fracture
A hand fracture is one of the most common hand conditions and can impose on daily activities vital to your personal and professional life. While the cause of hand fractures vary, your treatment plan may include multiple non-surgical and/or surgical interventions, which your physician will determine through physical and diagnostic evaluation. If you believe you have a hand fracture and would like to be evaluated, contact us today to receive timely evaluation and treatment from one of our experienced physicians. At the Hand Center of Louisiana, we maintain a 40-year legacy of delivering exceptional care to patients across the Gulf South.