An Overview of a Broken Hand

Symptoms, Causes, Diagnosis, and Treatment

Broken hands are painful, but not life-threatening. If the break is bad enough, there could be a loss of function or even a loss of part or all of the hand. So, a serious injury to the hand isn't going to kill you, but if a serious injury is left untreated, you could lose the hand.

Symptoms

The symptoms of a broken hand are similar to those of other broken bones and include:

  • Pain/tenderness
  • Swelling
  • Discoloration
  • Deformity
  • Inability to move (not required for a break — just because a hand can move doesn't mean it's not broken)

Causes

There are many situations that can lead to a broken hand, but most broken hands come from three distinct mechanisms of injury:

  1. Breaking a fall with an outstretched hand
  2. Crashing a vehicle or bicycle while hands are holding a steering wheel or handlebars
  3. Punching a hard surface

In most cases, a broken hand refers to a fracture of the metacarpals, which are the bones that connect the base of the fingers to the wrist. These are the bones of the palm. In some cases it refers to a fracture of the phalanges (finger bones), with or without a dislocation.

What to Do If You Think You Have a Broken Hand

Stay Safe! You might be amazed how many people, when trying to come to the rescue of an injured comrade, get hurt in exactly the same way. Whatever broke your buddy's hand (or one of your hands) could break yours (or your other one).

  • If the fingers of the injured hand are cold or blue, call 911 immediately.
  • Do NOT straighten the hand if it is deformed—keep it in the position found.
  • Stabilize the hand in the position of function (see photo) with the fingers curled loosely around a soft object like roller gauze. Use padding to keep it immobile.
  • Put ice on the injury. Never put the ice directly on the skin—make an ice pack. A little water in the ice pack will help it conform to the shape of the injury.
  • After holding ice on the hand for about 20 minutes, take it off for 20 minutes.
  • Anti-inflammatory drugs like ibuprofen, aspirin, or naproxen will help with pain. To decrease the risk of Reye's Syndrome, do not give aspirin to children under 19.
  • Elevate the hand above the level of the heart to reduce swelling.

If 911 was not called, seek medical assistance for additional pain relief and further evaluation of the injured hand. The use of an ambulance is probably not necessary, but ambulances in many areas are capable of providing additional pain relief.

Diagnosis

An x-ray is required to diagnose a broken hand. There is no other way to tell if the hand is broken or not. It's not possible to diagnose a broken hand simply by observing it for swelling, bruising, or lack of function.

Treatment

Most broken hands require some form of fixation to heal correctly and restore full function to the hand. The most common type of fixation is internal, using surgery to place pins through, or wires around, various bones to hold everything in place.

Fractures of the hand and fingers can also be treated without surgery as long as they can be held in proper alignment long enough to heal. This can be accomplished with a hand or finger splint.

During fixation, the doctor will usually treat pain with medications. Once the fracture is healed enough, you'll likely have to work on return of function using physical therapy.

Other broken bones require different specific treatments, depending on what's broken.

A Word from Verywell

Each hand (not counting the wrist) has 19 bones. I'd call that a target rich environment: a lot of potential for fractures. About 10% of all injuries seen in the emergency department are broken hands and fingers. With this much potential for injury and a high probability of loss of function, it's very important to have a doctor examine your hand if you think it might be broken.

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