Hand and Finger Fractures

What it is

The metacarpals are the bones of the palm, and the phalanges are the bones of the fingers and thumb. Fractures can be stable (aligned and unlikely to move), unstable (shifted), comminuted (in many pieces), or open, where bone breaks through the skin and raises the risk of infection.

What causes it

Hitting an object, crush injuries, and twisting injuries can all break hand bones. Punching something often breaks the metacarpal of the small finger, the so-called boxer's fracture. Crush injuries commonly break the fingertip.

Symptoms

• Pain, swelling, and stiffness
• Difficulty moving the hand or fingers
• A finger that looks crooked or rotated

Treatment

An examination and X-rays determine the treatment.

Without surgery: stable fractures are treated with a splint, cast, or buddy taping.

Surgery: fractures that leave a finger crooked, rotated, or unstable may be held with pins, plates, or screws. Severe injuries with missing or crushed bone may need a bone graft.

Recovery

A firm lump of healing bone (callus) often forms and shrinks over time. Some stiffness is expected, and hand therapy helps; stiffness can be slow to resolve even after the bone heals. Fractures near a joint can lead to arthritis later. Not smoking supports healing.