Hand Fractures

Hand fractures refer to breaks in one or multiple bones in the hand. It can cause a single crack or break to numerous fragments of hand bones. Sudden force or trauma can lead to hand fractures, a painful and potentially disabling injury. Hand fractures are common and can happen to anyone, from athletes to office workers to children. 

Understanding hand fractures is crucial for proper treatment and recovery. This article explores the symptoms of a broken hand, the causes and risk factors, potential complications, and how doctors diagnose and treat hand fractures. 

Symptoms of Fracture Hand 

Hand fractures can cause a range of symptoms that vary in severity depending on the location & extent of the injury. The following are some broken hand symptoms: 

• Severe pain, which often intensifies when gripping, squeezing, or moving the affected area 
• This pain can be accompanied by stiffness, making it difficult to move the hand, wrist, or fingers
• Swelling immediately after the injury 
• The fractured area may become tender to touch and show visible bruising
• A Broken bone in the hand can cause hand deformities, such as a crooked finger, a shortened finger, or a sunken knuckle (particularly in the case of a boxer's fracture) 
• Some individuals might notice their injured finger crossing over its neighbour when making a fist, a condition known as 'scissoring'

Other symptoms may include: 

• Numbness in the affected hand or fingers in the affected hand 
• Inability to move the fingers or thumb 
• A bony lump at the fracture site 
• Widespread bruising, which may appear far from the fracture site 
• Discomfort that persists even after the fracture has healed 
• It's important to note that the presence and severity of these symptoms can vary

Causes and Risk Factors of Broken Hand 

Hand fractures can occur due to various causes and are influenced by several risk factors. The following are some common causes of hand fractures: 

• Physical trauma 
• Falls are a leading cause, especially when people try to catch themselves with outstretched hands. 
• Direct blows or crushing injuries are also frequent causes of hand fractures. These can occur during accidents, such as motor vehicle crashes, or in contact sports like football, rugby, or hockey. 
• One specific type of hand fracture is the "boxer's fracture," which affects the fifth metacarpal bone supporting the little finger. This injury often results from punching or striking a hard object with a closed fist. 
• Other causes include accidents on job sites, especially when working with tools, and crushing of the hand. 
• Twisting injuries can also lead to hand fractures in some cases. 

Some risk factors can make individuals prone to hand fractures, such as: 

• People under 40 are at a higher risk 
• Athletes and sportspersons involved in contact sports or martial arts 
• Health conditions that affect bone strength, such as osteoporosis or osteopenia 
• Enchondromas, benign tumours growing inside bones, can also make fractures more likely. 

Complications of a Broken Hand 

Hand fractures can lead to various complications, even with proper treatment. These may include: 

• Hand stiffness 
• Reduced function 
• Difficulties with day-to-day activities even after three months 
• Persistent pain during certain activities, particularly during heavy activities or in cold weather. 
• Change in the grip strength. 
• Malunion of the broken bones, resulting in changes to the shape and size of the finger Nonunion is also possible where the bones fail to grow back together entirely or at all.

Rarely severe complications can occur. These include: 

• Bone infections (osteomyelitis) 
• Acute compartment syndrome, where pressure buildup in the muscles can cause permanent muscle and nerve damage 
• Osteoarthritis 
• Nerve or blood vessel damage 

To prevent complications, early diagnosis and treatment of hand fractures are crucial. 

Diagnosis 

When a hand fracture is suspected, doctors employ a combination of physical examination & imaging techniques to make an accurate diagnosis. 

• Physical Inspection: Doctors thoroughly assess the injury, including a detailed history of how the injury occurred. The doctor looks for signs of hand fractures such as swelling, bruising, deformity, and limited range of motion. They may also check for overlapping fingers, cuts around the injury site, and joint stability. 
• X-rays: An X-ray provides clear images of the bones, helping to identify the location and extent of the fracture. At least two different views, typically at 90-degree angles to each other, are required for accurate evaluation. X-rays also help detect foreign objects in the soft tissues, revealing signs of other conditions like arthritis or tumours. 
• CT Scan or MRI: If the fracture is complex or involves small bones or joints, doctors conduct a CT or MRI scan to get a more detailed view of soft tissues, ligaments, and bone fragments. 

Broken Hand Treatment 

The hand fracture treatment depends on the nature of the fracture, including which bone is involved, the fracture site, and the extent of deformity. These may include: 

• Non-surgical Treatment: Non-surgical treatment often involves a closed reduction, where the doctor realigns the bone fragments without making an incision. A cast, splint, or brace is then applied to keep the bones in alignment while they heal. 
• Medications: Doctors prescribe pain relievers to reduce pain. Broken hand specialists recommend an antibiotic course in case of an open fracture case to reduce the risk of infection that could reach the bone. 
• Surgery: For more complex broken hand fractures, surgery may be necessary. Surgical treatment may involve the use of pins, wires, screws, or plates to keep the bone fragments intact in place. 
• Rehabilitation: After treatment, rehabilitation exercises are crucial to reduce stiffness and restore movement. 

When to See a Doctor 

If you suspect a hand fracture, it's crucial to seek medical attention promptly. See a doctor: 

• If pain in your hand interferes with daily activities 
• If pain persists for more than two weeks despite home treatment 
• If you experience tingling or loss of sensation in your hand 
• If you face difficulty in moving your hand or holding objects 

Don't delay seeking medical advice if you're unsure about the severity of your injury. Prompt treatment for hand fractures can help ensure the best possible outcome & prevent potential complications. 

Prevention 

While it's impossible to foresee all events that might lead to hand fractures, there are steps you can take to reduce your risk. 

• Building strong bones is crucial in preventing broken bones in the hand. To achieve this, eat a nutritious diet rich in calcium & vitamin D. Engage in weight-bearing exercises or brisk walking regularly. 
• If you're a smoker, quitting can significantly improve your bone health. 
• Falls are a common cause of hand fractures, often occurring when people fall forward onto an outstretched hand. To prevent such injuries, wear sensible shoes and remove tripping hazards from your home, such as throw rugs. 
• Installing grab bars in your bathroom & handrails on stairways can provide additional support. 
• In the workplace, identifying potential hazards is the first step in preventing hand injuries. Mechanical, electrical, and chemical hazards are common across various industries. Employers should manage these risks responsibly, providing appropriate protective gloves as a last line of defence. 

Conclusion 

Hand fractures are serious injuries that can have a significant impact on daily life. Proper diagnosis and treatment ensure optimal recovery and prevent long-term complications. While some hand fractures may heal with conservative measures, others may require surgical intervention. The road to recovery is a combination of medical treatment and rehabilitation exercises. 

Prevention is crucial for reducing the instances of hand fractures. Building strong bones through a healthy diet, regular exercise, and taking precautions to avoid falls and workplace hazards can help protect your hands from injury. Remember, if you suspect a hand fracture, it's essential to consult orthopaedics promptly to ensure the best possible outcome and return to normal hand function. 

FAQs 

1. Is a broken hand always painful? 

A broken hand is typically painful, but the level of pain can vary. Most patients experience severe pain, which often intensifies when gripping, squeezing, or moving the hand. However, it's possible to have a fracture without significant pain. Some individuals might still be able to move their hands or make a fist with minimal discomfort, even with a fracture. 

2. How common are broken hands? 

Hand fractures are quite common. One in 10 of all broken bones is a metacarpal fracture. They're prevalent among people aged 18 to 34 and are often seen in athletes, especially those involved in contact sports or martial arts. 

3. Can you still move your hand if it's broken? 

You might be able to move and use your hand depending on which bone is broken and the fracture's severity. However, even if movement is possible, it's not advisable to force it, especially if it causes significant pain. 

4. How many days do I need to recover from a hand fracture? 

Recovery time for a hand fracture varies and depends on the severity and location of the break. Generally, a hand fracture takes about 6-8 weeks to heal. However, full recovery and return to normal activities may take 8-12 weeks. Some patients might continue to experience stiffness or discomfort for several months after the initial healing period. 

5. How to fix a broken hand at home? 

While it's crucial to seek professional medical care for a broken hand, there are some immediate steps you can take at home: 

• Remove any rings or jewellery 
• Elevate the hand to reduce swelling 
• Ice (wrapped in a cloth) was applied to the affected area 
• Cover any open wounds 
• Avoid moving the hand and seek medical attention as soon as possible. 

Dr. Sohael Mohammed Khan

MBBS, MS (Orthopaedics), Diploma (Spine Rehabilitation)
Ganga CARE Hospital Limited, Nagpur

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