Anatomy of Hand/Finger Fractures
If you think a broken (fractured) finger is a minor injury, think again. Without proper treatment a fractured finger can cause major problems. The bones in a normal hand line up precisely. They let you perform many specialised functions, such as grasping a pen or manipulating small objects in your palm. When you fracture a finger bone, it can cause your whole hand to be out of alignment. Without treatment, your broken finger might stay stiff and painful.
Dr. Jonathan Lee has a special interest and expertise in dealing with fractures of the hand and wrist. Together with his colleagues, Dr. Lee has contributed to the understanding and innovations in the treatment of these difficult fractures.
Causes and Symptoms
Your hand contains 27 bones. There are 8 bones-the carpals-in your wrist. The palm of your hand contains 5 bones called the metacarpals. The 14 bones in your fingers are called the phalanges. Fractures to the metacarpal bone that leads to your little finger accounts for about one-third of all hand fractures in adults.
Generally, a fractured finger occurs as the result of an injury to your hand. You can fracture a finger when you slam your fingers in a door or put out your hands to break a fall. You can fracture a finger during a ball game if the ball jams your finger. Carelessness when working with power saws, drills, and other tools can result in a fractured finger.
COMMON SYMPTOMS
Swelling of the fracture site.
Tenderness at the fracture site.
Bruising at the fracture site.
Inability to move the injured finger in completely.
Deformity of the injured finger.
Diagnosis
If you think you fractured your finger, immediately tell your doctor exactly what happened and when it happened. Your doctor must determine not only which bone you fractured, but also how the bone broke. Bones can break in several ways. They can break straight across the bone, in a spiral, into several pieces, or shatter completely.
Your doctor may want to see how your fingers line up when you extend your hand or make a fist. Does any finger overlap its neighbour? Does the injured finger angle in the wrong direction? Does the injured finger look too short? Your doctor may X-ray both of your hands to compare the injured finger on your uninjured finger on your other hand.
Treatment and Rehabilitation
NON-SURGICAL TREATMENT
Your doctor will put your broken bone back into place, usually without surgery. You'll get a splint or cast to hold your finger straight and protect it from further injury while it heals. Sometimes your doctor may splint the fingers next to the fractured one to provide additional support. Your doctor will tell you how long to wear the splint. Usually a splint on a fractured finger is worn for about three weeks. You may need more X-rays as you heal so your doctor can check the progress of your finger as it heals.
SURGICAL TREATMENT
Depending on the type and severity of the fracture, you may need surgery to have pins, screws, or wire put in place to hold your fractured bones together.
REHABILITATION
Begin using your hand again as soon as your doctor determines it is okay to move your finger. Doing simple rehabilitation exercises each day will help reduce the finger's stiffness and swelling. You may be required to see a physical therapist to assist you in these exercises.
See some of Dr. Lee’s publications on the subject:
Inter-fragmentary screw fixation of proximal interphalangeal joint fracture dislocations – indications and results.
Lee JYL, Teoh LC. J. Hand Surg (Br.) Apr 2006; 31B(2): 138-146.
Top 10 Downloaded 1996, J Hand Surg (Br/Eur).
Mallet Fractures: A novel approach to internal fixation using a hook plate.
Teoh LC, Lee JYL.. J. Hand Surg (Br.) Feb 2007; 32(1): 24-30
Voted Top 10 Downloaded 1997 Jan-Jun, J Hand Surg (Br/Eur).
