Hand Fractures

Selected Features of Our Program

Evaluation and Diagnosis

Any of the small bones in the hand can be easily fractured. Damage ranges from simple cracks sustained during sports up to major open crushing injuries from heavy machinery. Symptoms are pain, swelling, and deformity. In more severe injuries, the skin may be opened with additional injury to tendons, nerves, or blood vessels. X-rays reveal the pattern, location, and severity of the fracture. Hand fractures have tremendous potential to create both severe stiffness and to heal in the wrong position. Serious and permanent loss of hand function can result. For this reason, being seen immediately after injury by an expert in this field is critical to plan the best treatment.

Treatment and Recovery

There are three options for treatment: splinting only, stabilization of the bones by smooth pins and no incisions, and opening the fracture up to reposition it and place very strong fixation in the bones. If the fracture is already sitting in the correct position, proper splinting can allow the patient to avoid surgery. This option is chosen whenever possible. If the fracture won't stay in the right position, it must be stabilized during the body's healing period. This can be accomplished with smooth pins under limited anesthesia as a short outpatient surgery. The pins are taken back out by 4 weeks in the office and therapy exercises follow. Only in the more severe fracture patterns will there be an advantage to opening the fracture site to achieve better stabilization.

After surgery, a splint is applied. Stiffness is very common with these fractures and is counteracted by starting gentle exercises under the guidance of a hand therapist. Most fractures will heal partially within 4-5 weeks and completely by 10-12 weeks. Basic light activities such as computer and writing can usually be done even before the fracture is healed. Most patients are able to return to their previous work activities with minimal restrictions.