Hand fractures are breaks or cracks in one of the bones in the hand. There are many bones in the hand, including bones such as the metacarpals (the long bones within the palm) and phalanges (the small bones of the fingers). These bones are commonly broken as a result of blunt trauma. This trauma may include a fall, twisting injury, crush injury and or through direct contact in sports.
A particularly common fracture is called a "Boxer's fracture". This is a fracture of the metacarpal of the little finger and occurs at the time of a punch. This hand fracture normally occurs at the neck of the fifth metacarpal bone that is next to the knuckle joint. Signs and symptoms of a hand fracture include swelling of the hand, bruising, inability to move the finger and tenderness or pain. Boxer's fractures can cause symptoms such as knuckles that look sunken in or depressed. This is caused by the displacement or angulation of the end or head of the metacarpal bone.
The vast majority of hand fractures do not need surgery and can be treated in a splint. There is a huge variety of different types of fractures in the hand. Again, most of these do not need surgery and do well with splinting and rehabilitation. A common complication of hand injuries and fractures is stiffness, so hand therapy plays an important role in treatment. The indications for surgery would include malrotation, or severe angulation and displacement. Surgery is often required if you have an open fracture, a fracture which extends into the joint, and loose bone fragments that may enter a joint. The orthopaedic surgeon may use wires, plates and screws to reduce and hold the bones in place while they heal.
If you have a fracture of one of the bones in the hand, it should be assessed by your doctor and a decision made as to whether splinting or surgery is required.