Hand and Finger Fractures: Treatment Options

Hand and Finger Fractures: Treatment Options

After determining the type of hand or finger fracture through an x-ray, a health care provider will determine what type of treatment is needed to help the fracture heal. Both fractures to the hand bones, or metacarpals, and finger bones, or phalanges, are treated in similar ways.

If a fracture is simple and stable, it can often be treated without surgery. Usually, the bones need to be prevented from moving in order to heal properly. If needed, a health care provider can realign the broken bone, referred to as closed reduction, before applying a splint or a cast to stabilize the hand and fingers, allowing a fracture to heal.

The hand is typically placed in the intrinsic plus position, also called the safety position. This position prevents muscles and ligaments from getting too tight near the hand and finger joints, which can result in a permanent loss of range of motion after the fracture is done healing.

For simple finger fractures, splinting or buddy taping, where the broken finger is stabilized by being taped to the finger next to it, is often enough to allow the fracture to heal. More complex fractures require surgery. These include displaced, unstable fractures that shift the bones out of normal alignment and cannot be fixed with closed reduction, multiple fractures, open fractures that break through the skin, or fractures that result in bone loss.

A variety of different surgical options are available to treat hand and finger fractures. These include using metal wires, bone nails, small screws, plates and screws, or external fixation. These metal implants will stay inside the body as the fracture is healing. In some cases, they may be removed after the bone has healed. The type and location of the fracture will help a surgeon determine which type of surgical technique is best to stabilize the broken bone.

Comminuted fractures, where a bone shatters into many pieces, often need a bone graft to be used during surgery to fill in the gap of missing bone that cannot be repaired. This helps restore the proper length and strength of the bone.

Whether surgery is needed or not, all types of fractures will be monitored with x-rays over several weeks or months to make sure that they are healing properly. Depending on the type of fracture and if surgery was performed, a health care provider may recommend physical therapy or occupational therapy. Patients will perform a variety of finger, hand, and wrist exercises to improve range of motion, grip strength, and fine motor movement needed for activities of daily living. Fractures will take several weeks to heal but may require several months to restore motion and function in the hands and fingers.