Hand Fracture

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• QI fell on my wrist and hand, and it still hurts. Should I be worried?

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  A Dr. Rachel S. Rohde, MD , Orthopedic Surgery, answered

  Scaphoid fractures result from a fall onto your outstretched hand. You might have pain, swelling, and/or bruising. This commonly is misdiagnosed as a “sprain” and unfortunately not discovered until long after the injury.

  Initial X-rays might or might not show the fracture. If you have a lot of tenderness at the “snuffbox” at the base of the thumb side of the wrist, a scaphoid fracture should be suspected and you should be placed in a splint and reevaluated in a few weeks, when the break might be more visible on the X-ray. An MRI also can be used to determine early whether there is a fracture.

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• QWhat causes a hand fracture?

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  A Dr. Rachel S. Rohde, MD , Orthopedic Surgery, answered

  Believe it or not, there are 19 bones in each of your hands and 8 in each wrist, not including those big long forearm bones. These bones and the joints between them provide protection and support for the many tendons, muscles, nerves, blood vessels and ligaments that work together to make your hands function so well!

  When a significant force is applied to your bone, it can break (or fracture, which is the technical term for “break!”). This causes pain, stiffness, bruising, or even bleeding if there is a break in the skin. Sometimes you will see a deformity (your finger might look crooked). 

  
  
• QHow is a hand fracture diagnosed?

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  A Dr. Rachel S. Rohde, MD , Orthopedic Surgery, answered

  Swelling, bruising, tenderness, pain, or changes in motion after an injury to the hand are suspicious for a fracture; Xrays will help your hand doctor diagnose and plan your treatment with you.
• QHow is a hand fracture treated?

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  A Dr. Rachel S. Rohde, MD , Orthopedic Surgery, answered

  Treatment of hand fractures depends on your age, what bone is broken and where/how in that bone, whether your fingers are malrotated or “scissoring” over each other, and other factors. Your hand doctor can examine you and your X-rays to determine whether the fracture needs to be reduced (or “set”) and whether it can be treated in a splint/cast or might need surgery.

  Once your doctor considers your fracture “stable” enough, you might be sent for hand therapy to start motion. Early motion helps prevent stiffness, but there always is a balance between early motion and stability of the fracture.

  
  
• QWhat are the risks of having a hand fracture?

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  A Dr. Rachel S. Rohde, MD , Orthopedic Surgery, answered

  The biggest risk of most hand fractures is loss of function; usually, the loss is related to motion. Hand fractures that are not treated/followed can result in malrotated fingers that overlap or excessive stiffness. This is why it is so important to seek medical attention even for "just a broken finger."