Broken Hand

Broken Hand Facts

The hand is a marvelously complex part of the human anatomy. Every year, however, millions of people experience broken bones within their hands. Because we are so dependent on our hands, even a small loss of function can result in a lifelong disability. A broken hand will often require a visit to a doctor, and it may require months of rehabilitation care.

  • The hand is composed of 27 bones, including those in the wrist. Broken bones most commonly result from a direct blow to or by the hand, or a fall onto the hand. Common injuries include fractures of the fingertip, broken knuckles, or fractures of the thumb.
  • When doctors describe the bones in the hand, they use several terms.
    • Carpals or carpal bones are the 8 bones in the wrist. They are not actually part of the hand but are vital for its function.
    • Metacarpals are the 5 bones that form the palm of the hand.
    • Phalanges are the 14 small bones that, when strung together, form the thumb and fingers. The thumb has 2 phalanges. The other 4 fingers are made of 3 phalanges each.
    • The knuckles of the hand are referred to as the MCP joint, which stands for metacarpal-phalangeal joint (because the fingers, composed of phalanges, join the palm, made of metacarpals).
    • The joints in the fingers are called the PIP and DIP joints. The PIP joint is the proximal interphalangeal joint and is the joint closest to the palm. The DIP joint is the distal interphalangeal joint and is the joint closest to the fingertip.
    • The fingers are called the thumb, index finger, middle (or long) finger, ring finger, and pinky (or small) finger. Sometimes your health care practitioner might refer to your fingers by number, in which case the 1st digit is the thumb, and the small finger is the 5th digit.
    • The handedness (right or left) of the person is called the dominance of the hand. If you are left-handed, then you are left-hand dominant.

What Causes a Broken Hand?

Hand injuries are caused by workplace injuries, improper use of tools, blunt trauma to the had (punching or striking injuries) crush injuries, falls, and sports injuries. The vast majority of hand injuries can be prevented.

Picture of the Bones in the Hand

Bones of the Hand
Bones of the Hand

What Are the Symptoms of a Broken Hand?

Most injuries of the hand are fairly obvious. The symptoms may include the following:

  • A history of injury
  • Swelling
  • Bruising
  • Pain
  • Misalignment of the finger
  • Weakness
  • Inability to grasp
  • Reduced range of motion of fingers

When Should I See a Doctor for a Broken Hand?

Because the hands are so important, see a doctor for any injury to the hand unless it is very minor. The hands are central to being able to function, and a person should be certain that no permanent damage has been done.

Contact a doctor, who will often refer the injured person to the emergency department, an orthopedist, or a hand specialist for diagnosis and treatment.

How Is a Broken Hand Diagnosed?

Most injuries of the hand will require an X-ray. The history of how the hand was injured will help the doctor determine the most likely fracture. For example, if the hand was injured by punching, the most likely fracture is that of the 5th metacarpal.

The doctor will examine your fingers, hand, and wrist to determine the areas that are most painful and to evaluate if any damage has occurred to the blood vessels or nerves or tendons in the hand.

Are There Home Remedies for a Broken Hand?

Generally, any hand injury-except for the most minor one-should be seen by a doctor. Simple first aid, however, can help prevent further injury.

  • Control any bleeding by placing a clean cloth or gauze pad over the wound and apply direct pressure.
  • As soon as the injury has occurred, apply ice wrapped in a towel to the injured area to decrease pain and reduce swelling.
  • Remove any jewelry immediately. The hand may swell dramatically, and jewelry will be almost impossible to remove after the swelling has started. Jewelry on the hand may have to be cut off by a health care practitioner if there is a chance that it will impede the circulation of the fingers.
  • Contact a doctor, who will often refer the injured person to an emergency department, orthopedist, or hand specialist for diagnosis and treatment.
  • If the hand is obviously deformed, try to support the injured hand by placing it on a pillow and carrying the pillow to the hospital or doctor's office.
  • Take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as directed on the label for pain and inflammation.

What Is the Treatment for a Broken Hand?

Because of the complexity of the hand, treatment of hand injuries can become involved. The procedure is usually as follows:

  • The doctor will usually obtain an X-ray.
  • The injured hand may be partially numbed by injecting the nerves at the wrist or at the base of a finger (digital block). Wounds will be carefully irrigated and explored.
  • Any cuts usually will be repaired.
  • The patient may be prescribed antibiotics to keep the wound from becoming infected.
  • The injured part may be immobilized in a splint to hold it in a particular position.
  • The patient may be referred to a hand specialist (orthopedic or plastic surgeon).
  • The patient will receive pain medicine to use for several days after the injury.

What Is the Followup for a Broken Hand?

After the patient leaves the hospital or doctor's office, they can make the healing process as successful as possible by following this advice.

  • Read any instructions provided by the hospital and ask questions about those that you do not understand.
  • If the hand or finger(s) are placed in a splint, do not remove it until told to do so.
  • Keep the injured hand elevated as much as possible. This will reduce pain and decrease swelling.
  • Keep all follow-up appointments and take all medication as directed.

How Do I Prevent a Broken Hand?

The vast majority of injuries can be prevented.

  • To prevent hand injuries on the job :
    • Look for hand hazards before an accident can happen.
    • Don't use your hands to wipe away debris in a machine; use a brush that is designed for that purpose.
    • Check your equipment and machinery before you start and after you finish. Be sure that it is in good operating condition.
    • Before you repair or clean machinery, be sure that the power is disconnected and follow all safety procedures.
    • Do not wear jewelry, or loose clothing when working near a machine with moving parts.
    • Wear the correct protective equipment-gloves, guards, forearm cuffs-for the work you are doing.
    • Be sure your gloves fit properly and are meant for the work you are doing.
  • Use appropriate safety equipment while playing sports to prevent or limit the extent of fractures.
    • Hand and wrist guards are appropriate when playing certain sports (rollerblading, lacrosse, hockey).
    • Sports that involve a ball (football, basketball, baseball, softball, volleyball) are more likely to cause hand injuries. Take special care when playing these games.
  • Practice household safety measures, especially with small children, to decrease the chances of all injuries, including those to the hands.
  • Get timely medical evaluation and treatment to prevent the long-term disability of a hand injury.
  • Avoid using your hands to punch, hit, or pound any objects in anger. Many injuries to the hands are self-inflicted in this manner.

What Is the Prognosis for a Broken Hand?

Because hand injuries and finger injuries can be handicapping, it is extremely important that they are evaluated promptly and thoroughly.

The prognosis and healing time depends on whether the injury involved a joint, whether tissue was lost, whether infection occurred, and often how well you follow instructions. Many seemingly minor fractures will require surgery followed by physical therapy to regain the maximum amount of function.

Reviewed on 12/8/2017

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

MedscapeReference.com. Hand, Metacarpal Fractures and Dislocations.

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