Hand Fractures Treatment
Hand fractures can be skilfully treated by Dr Oscar Brumby-Rendell.
Hand fractures are breaks in one or more of the bones in the hand. They can result from trauma, such as a fall, direct impact, or accidents.
Dr Oscar Brumby-Rendell is an orthopaedic surgeon in Adelaide specialising in hand and wrist injuries and treatments, offering both surgical and non-surgical treatment options for hand fractures.
Understanding Hand Fractures
The human hand is a complex and intricate structure consisting of 27 bones, including the carpal bones (wrist bones), metacarpal bones (bones of the palm), and phalanges (finger bones). The hand is crucial for performing everyday tasks, providing dexterity, strength, and precision in movements.
Causes of hand fractures include:
- Trauma: Direct impact from falls, sports injuries, or accidents.
- Repetitive Stress: Overuse or repetitive motions that lead to stress fractures.
- Medical Conditions: Conditions like osteoporosis can weaken bones, making them more susceptible to fractures.
Types of hand fractures include:
- Metacarpal fractures involve the long bones in the palm, often caused by direct blows or twisting injuries.
- Phalangeal fractures affect the finger bones, usually from crushing injuries, falls, or sports injuries.
- Mallet fractures occur when the extensor tendon is damaged, often from a sudden impact on the fingertip.
Receive expert care for hand fractures
Symptoms of Hand Fractures
Common signs and symptoms of hand fractures include:
- Immediate and severe pain, worsening with movement or pressure
- Swelling, often with bruising or discolouration
- Tenderness to the touch
- Visible deformity or abnormal finger/hand position
- Difficulty or inability to move the hand or fingers
- Numbness or tingling
- Weakness or inability to grip objects
Identifying a Hand Fracture
Identifying a hand fracture involves recognising the signs and understanding when to seek medical evaluation. Here are some steps to help identify a hand fracture:
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- Assess for pain at the injury site.
- Look for swelling and bruising.
- Check for visible deformity (e.g., misaligned fingers or abnormal bumps)
- Test range of motion
- Evaluate numbness and tingling
- Assess grip strength
Diagnosing Hand Fractures
- Physical Examination: Dr Oscar Brumby-Rendell will assess pain and tenderness, examine swelling and bruising, check for deformities or misalignment, evaluate range of motion, and test sensation and strength.
- Imaging Tests: X-rays provide detailed images of the bone to reveal the fracture’s presence, location, and severity, while CT scans are used in complex cases for a detailed, cross-sectional view to identify fractures not clearly visible on X-ray.
An early and accurate diagnosis prevents complications like improper healing, chronic pain, stiffness, and permanent deformity, and ensures timely and effective treatment, optimising healing and recovery.
Treatment Options for Hand Fractures
Hand fractures, or broken bones in the hand, can significantly affect a person’s ability to perform daily tasks. Treatment options for hand fractures depend on the location and severity of the break.
Non-Surgical Treatments
Surgical intervention is needed when non-surgical treatments can't ensure proper healing. Techniques vary based on fracture type, location, and severity:
Non-surgical treatments are often sufficient for less severe fractures, promoting healing while maintaining hand function.
This method uses medical tape to bind the injured finger to a neighbouring finger, allowing them to move together and prevent further damage. Padding may be added to reduce skin irritation. Buddy taping maintains joint flexibility and muscle strength while stabilising the fractured finger.
A splint provides rigid support to immobilise the fractured area, reducing pain and preventing further injury. Splints can be made from plaster, fiberglass, or other materials and are custom-fitted. There are a variety of splints that are typically made by hand therapist:
- Gutter Splint: Most often used for fractures of ring or little finger, the splint supports the outside of the hand cradling the ring and little finger.
- Mallet splin – Specific for fractures of the end joint or knuckle of a finger or thumb. It locks the end joint straight to help the small bone fragment and tendon heal.
- Finger/Hand based static splint – splints used to hold the finger completely immobilised whilst awaiting for fracture healing.
- Thumb Spica Splint: Used for thumb fractures, this splint immobilises the thumb while allowing movement of the finger.
Rest and immobilisation minimise stress on the fracture and are crucial for healing. Avoid activities that strain the hand. The immobilisation period varies but usually lasts from a few weeks to several months.
Pain can be managed with over-the-counter pain relievers, ice packs, and keeping the hand elevated. Effective pain management improves comfort and compliance with rest and rehabilitation.
Surgical Treatments
Uses screws to hold bone fragments together, ideal for simple, non-comminuted fractures. Provides stable fixation, allowing early movement and quicker recovery. Suitable for long bone fractures in fingers, metacarpal fractures, and minimally displaced fractures.
“Key hole” Intramedullary screw fixation: This relatively new method involves inserted a specific type of screw down the middle inside the bone, holding it in alignment. This technique can be done through small ‘keyhole’ incisions and allow early range of motion. It has a big advantage in hand surgery as open surgery with plates can often cause adhesions leading to stiffness.
Involves attaching a metal plate with screws for added stability, ideal for complex fractures with multiple fragments. Used for comminuted fractures, significantly displaced fractures, and fractures involving joint surfaces.
Utilises wires to stabilise bone fragments, effective for small bones or fragments. Minimally invasive and often combined with other methods, useful for fractures in the phalanges and metacarpals. Suitable for small, comminuted fractures and fractures at the base of the metacarpals.
Certain types of hand fractures require surgical intervention to ensure proper healing and function. These include:
- Complex or Comminuted Fractures: When the bone is broken into several pieces, aligning these fragments through surgery is often necessary to restore the hand’s anatomy and function.
- Unstable Fractures: Fractures that cannot be maintained in a stable position with splinting or casting alone require surgical fixation to prevent displacement during the healing process.
- Open Fractures: When a fracture is accompanied by an open wound, surgery is needed to clean the wound, remove debris, and stabilise the bone to prevent infection and ensure proper healing.
- Displaced Fractures: Fractures where bone fragments are significantly out of alignment. Surgery is required to realign the bones correctly to restore function and appearance.
- Intra-articular Fractures: Fractures that extend into a joint surface. Surgical intervention is necessary to restore joint congruency, prevent arthritis, and ensure joint function.
- Non-union or Delayed Union: Fractures that have not healed appropriately within the expected timeframe may require surgical intervention to promote bone healing.
Personalised treatment plans available for hand fractures
Recovery and Rehabilitation
Immediate Post-Treatment Care: Your hand will be immobilised with a cast, splint, or brace. Elevate the hand and apply ice to reduce swelling. Use prescribed pain medications and follow wound care instructions if surgery was performed to avoid infection.
Typical Recovery Timeline: Manage pain and swelling in the first few days. After 1-2 weeks, swelling should decrease, with a follow-up appointment likely. Between 3-6 weeks, bones start to heal, and immobilisation continues. If surgery has been performed to stabilise the fracture, we can often start range of motion exercises straight away. By 6-8 weeks, the cast or splint may be removed for gentle movements and physical therapy.
Physical Therapy Exercises: Once approved, start with range of motion exercises (finger bends, spreads, wrist flexion). Strengthening exercises (squeezing a soft ball, lifting fingers, resistance bands) and coordination exercises (picking up small objects, finger tapping) will help restore dexterity.
Frequently Asked Questions
Immediately after fracturing your hand, immobilise your hand or try to keep it as still as possible and seek immediate medical attention.
Recovery time can vary, but generally, it takes about 6-8 weeks for a hand fracture to heal. The exact duration depends on the fracture’s complexity and the individual's overall health.
Resuming normal activities depends on the fracture's healing progress and your doctor’s recommendations. Typically, light activities can be resumed after the cast is removed, but full activity should only be restarted following physical therapy and approval from your healthcare provider.
Yes, once your doctor gives the go-ahead, physical therapy exercises such as range of motion exercises, strengthening exercises, and coordination tasks are important for recovery. Your physical therapist will guide you through appropriate exercises based on your condition.
Why Choose Dr Oscar Brumby-Rendell?
Dr Oscar Brumby-Rendell is a highly trained orthopaedic surgeon in Adelaide specialising in upper limb conditions. He brings a wealth of experience to his practice, prioritising his patient’s needs and preferences and ensuring they receive the highest standard of care. Dr Brumby-Rendell’s commitment to his patients is evident through his passion for providing personalised treatment plans and compassionate care.
Schedule a Consultation
Experience expert care for hand and wrist fractures. To schedule a consultation, simply contact as at (08) 7077 0101 or book online. Dr Oscar Brumby-Rendell operates from Dulwich, Bedford Park, and Stirling in Adelaide.
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