Fractures in the Hand, Wrist or Fingers

What are hand, wrist or finger fractures?

Fractures of the hand, wrist or fingers are common injuries that can make everyday activities — such as gripping, typing or lifting — painful and difficult. A fracture is a break in one of the small bones of the hand, wrist or fingers, most often caused by a fall, sports injury, work accident or a direct blow.

These injuries can range from small hairline cracks to more severe breaks where the bone is displaced or, in rare cases, breaks through the skin. In the hand and wrist, even a seemingly minor fracture can significantly affect your ability to pinch, grip or rotate your forearm. With prompt, expert care at Novant Health, most fractures heal well and allow you to return to the activities you enjoy.

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How fractures affect the hand

The hand, wrist and fingers are made up of many small bones — including phalanges (fingers), metacarpals (hand) and carpal bones (wrist) — connected by joints, ligaments and tendons. A fracture can disrupt this alignment, causing pain, swelling and limited motion. Fixation helps hold the bones in the correct position during healing and can help prevent deformity and stiffness that affect grip strength and dexterity.

Overview

Symptoms

Symptoms depend on which bone is injured, but may include:

Pain, swelling and bruising in the hand, wrist or finger after an injury
Trouble moving or using the hand, difficulty gripping or pinching or weakness
Visible deformity, or a finger or wrist that looks “out of place,” shortened or rotated
Numbness, tingling or severe swelling, which can signal nerve or circulation problems and needs urgent care

Any open wound near a painful, swollen hand or wrist may indicate an open (compound) fracture and is a medical emergency.

Causes

Hand, wrist and finger fractures can happen in many situations, including:

Falls onto an outstretched hand during daily activities or sports
Sports collisions, ball-impact injuries or being hit by equipment
Work-related accidents, such as crush injuries, machinery incidents or heavy lifting
Motor vehicle accidents or other high-energy trauma
Twisting injuries or direct blows to the hand, such as punching something and causing a boxer’s fracture

Diagnosis

Your hand and wrist surgeon will talk with you about how the injury happened and examine your hand, wrist and fingers for tenderness, motion, sensation and alignment. They will typically use X-rays to confirm the fracture, see how far the bone has moved out of place and help guide treatment. In some cases, they may recommend advanced imaging for more complex injuries.

Seeing a hand and wrist specialist early helps ensure the bone is properly aligned and stabilized before it begins to heal in the wrong position.

Why treatment matters

Treatment depends on which bone is broken, how far it is out of place, whether joints are involved and your activity level. We can treat many fractures without surgery, while others heal best with surgical repair

Nonoperative care

Nonoperative treatment may include:

Splinting or casting to hold the bone in the correct position while it heals
“Setting” (reducing) the fracture before splinting or casting if it is out of alignment
Pain management, swelling control and referral to hand therapy when needed

Operative care

We may recommend surgery if the bone cannot be properly aligned or kept stable in a cast, if the fracture involves a joint, or if healing problems such as malunion or nonunion occur. During surgery, your hand surgeon may use pins, screws or plates to hold the bone securely while it heals and help restore hand function as fully as possible.

Take the next step

Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.