Did you know more than one in 10 people with hand injuries have a fracture of one of the hand bones?
1. What is a fracture?
A fracture occurs when there is a break in a bone. This can occur after a fall, during sporting activities, in the workplace, in a road trafﬁc accident or by the rotating blades of a drone as happened to singer Enrique Iglesias during his concert in Tijuana, Mexico.
2. Types of fracture
Fractures may be simple; consisting of two bone fragments still in alignment; or comminuted, where the bones have shattered into many small pieces. An open fracture – also known as a compound fracture- is one where there is an open wound as a result of the bones penetrating the skin. This increases the risk of infection and requires urgent treatment. Comminuted and open fractures are usually caused by high-energy forces and typically include other injuries to soft tissue like tendons, nerves, blood vessels and skin. All these will also need to be treated to ensure optimal recovery after injury.
3. A fracture in a hand bone will usually cause:
- Intense pain at the fractured site that worsens with movement
- Swelling around the area
- Inability to move the ﬁnger/s and hand
- Bleeding or broken bone pieces visible in the wound in open fracture
4. What to do when you fractured your hand?
If a fracture is suspected, ﬁrst- aid treatment will consist of immobilising the injured part with a splint. Cold compression and elevating the injured part will relieve pain and prevent swelling. Remove any rings that may become constrictive due to the swelling. Stop any bleeding by applying pressure to the wound with a sterile bandage or a clean cloth. Do not use a tourniquet. Your hand surgeon will examine you to assess the severity of the injury and order X-rays. Sometimes, more detailed investigations such as CT scans or MRI may be needed if other concomitant injuries are suspected. Your hand surgeon will recommend the most appropriate treatment depending on the type of fracture.
5. What happens when fractures are not properly treated?
When fractures are not treated or improperly treated, complications can occur. For instance, stiffness of the ﬁngers and hand that prevents a useful grip is common, while deformity of the ﬁnger joints sometimes occurs, and limits full extension of the affected ﬁnger. Loss of extension can also be a result of the fractured bones overlapping, as this effectively shortens the ﬁnger. Finally, if the fractured bones heal in a malrotated position, the ﬁngers can end up overlapping when gripping and this will interfere with function. Intra-articular fracture can also lead to painful early osteoarthritis of the joint.
Although hand fractures are common and can cause prolonged morbidity and lead to signiﬁcant permanent functional impairment, but with proper care and treatment, you should be able to resume your usual activities in no time.