Fractures of the Hand and Fingers
Metacarpal hand fracture and Proximal Phalanx fractures are shown here, highlighted in red.
5th Metacarpal hand fracture
Metacarpal hand fracture and Proximal Phalanx fractures are shown here, highlighted in red.
Why Does it Occur?
Fractures of the hand and fingers are generally caused by a fall or trauma to the area. Patients commonly ask if the bone is broken or fractured. These terms actually mean the same thing. How the fracture is treated depends on many factors such as the position/displacement of the fracture, how many fragments are involved, how long ago the injury occurred, as well as other anatomical features such as angulation of the fracture or if other bones are involved.
Symptoms
Patients most commonly present with pain and swelling near the affected bone. Patients may also experience bruising, stiffness and loss of movement. It is important to note that being able to open and close your fingers without much pain does NOT rule out you having a fracture
Diagnostic Testing
X-rays are advised for all suspected fractures. Sometimes fractures can’t be adequately seen on x-ray. In these cases, Dr. Lee may consider additional imaging studies such as a CT scan, MRI, or Bone Scan
Treatment Options
Treatment options for hand and finger fractures depend on the type of fracture, patient age, fracture position, degree of healing, involvement of neighboring bones, baseline functional status, and how quickly the patient needs to return to activity/sports/work. Taking all of these factors into consideration, Dr. Lee will recommend a plan for your specific fracture.
Nonoperative treatment options include fracture reduction/manipulation, splinting, or casting. Elevation of the hand above the level of the heart can help minimize swelling. In general, non-operative fractures are typically immobilized for 6 weeks followed by a 6 week period of therapy. This is a general guideline that often varies from patient to patient.
Surgical Treatment
Surgical options include either the use of small metal pins placed through the skin and into bone OR the use of plate and screws. Both methods will reduce your fracture to its correct anatomical position and allow for anatomic healing. The decision between which method to use depends on a variety of factors that will be further discussed with you at your visit. Pins will eventually be removed (usually between 4-6 weeks after surgery), while plate and screws are usually not removed.
Dr. Steven J. Lee is the Chief of Hand and Upper Extremity at Lenox Hill Hospital and an expert in fracture care. He has also helped to design one of the premier skeletal fixation systems used to treat the most complex fractures in the upper extremity. To view a webinar about this fracture system, click here.
Learn more about scheduling surgery.
Recovery Expectations
You will either be placed into a splint or cast at your first post-op appointment. This decision is dependent on your fracture type and surgery. Healing of fractured bones is dependent upon a number of factors and can take anywhere from 4-12 weeks. If pins were placed, you will need to keep those pins dry and avoid sweating until the pins are removed (usually between 4-6 weeks post-op). Physical therapy is usually instituted around 6 weeks post-op. Physical therapy may continue for 6-12 weeks and is an extremely important part of the recovery process.
Immediate Post-Operative Instructions
Please refer to the following pages for more information:
*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.
*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.