HAND FRACTURES

What is a fracture?
The hand skeleton is made up of many bones that form its supporting framework. This frame acts as a point of attachement for the muscles that make the wrist and fingers move. A fracture occurs when force is applied to a bone that is enough to break it. When this happens, there is pain, swelling and decreased use of the injured part. Many people think that a fracture is different from a break, but they are the same. Fractures may be simple with the bone pieces aligned and stable. Other fractures are unstable and the bone tends to displace or shift. Comminuted fractures (shattered bone) usually occurs from a high energy force and are often unstable. An open (compound) fracture occurs when a bone fragment breaks through the skin. There is some risk of infection with compound fractures.

Sign and symptoms

• Pain
• Stiffness
• Loss of Movement
• Weakness

Treatment
Medical evaluation and X-rays are usually needed so that your doctor can tell if there is a fracture and to help decide treatment. Depending upon the type of fracture to your hand, your hand surgeon may recommend one of several methods of treatments.

Some displaced fractures may be held in place with wires or pins without making an incision. This is called closed reduction and internal fixation. Other fractures may need surgery to set the bone. Once the bone fragments are set, they are held together with pins, plates, or screws. Occasionally bone may be missed or be so crushed that it cannot be repaired. In such cases, a bone graft may be necessary. In this case, bone is taken from another part of the body to help provide more stability.

Fractures that have been set may have been held in place by an "external fixator," a set of metal bars outside the body attached to pins which are fixed to the bone above and below the fracture site until the break heals.

What kind of results can I expect?
Perfect alignment of the bone on X-ray is not always necessary to get good function. A bony lump may appear at the fracture site as the bone heals and is known as fracture callus. This functions as a "spot weld." This is a normal healing process and the lump usually gets smaller over time. Problems with fracture healing include stiffness, shift in position, infection, slow healing, or complete failure to heal. Smoking has been shown to slow fracture healing. A hand therapy program with splints and exercises may be recommended by your physician to speed and improve the recovery process.