Comprehensive Guide to Hand Fractures and Recovery
Cotswold Hand Surgery
Cotswold Hand Surgery offers expert solutions for hand fractures, ensuring effective hand operation recovery. With tailored treatments, including non-surgical options and advanced surgical procedures, your hand's functionality and health are our priority. Count on us for professional care and guidance throughout your recovery journey.
Hand Fractures
What is a Hand Fracture?
A hand fracture is a break in one of the bones of the hand. The hand contains metacarpal bones (in the palm) and phalanges (finger bones), and fractures can occur in any of these bones.
Hand fractures are common injuries and usually occur following trauma such as a fall, direct blow, or twisting injury. Depending on the severity and position of the fracture, symptoms may range from mild discomfort to significant pain, swelling, and deformity.
Some fractures are stable and can be treated with splinting alone, while others may require surgery to restore alignment and allow the hand to function normally.
Causes and Risk Factors
Hand fractures are most commonly caused by trauma. Common causes include:
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Falls, particularly onto an outstretched hand
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Direct blows, such as punching an object or impact during sports
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Crush injuries, for example from machinery or heavy objects
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Twisting injuries, particularly during sporting activities
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Road traffic accidents
Factors that may increase the risk of hand fractures include:
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Participation in contact sports
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Manual occupations
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Reduced bone strength, such as in osteoporosis
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Previous fractures or injuries to the hand
Symptoms
The symptoms of a hand fracture can vary depending on the location and severity of the injury, but common signs include:
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Pain in the hand or finger, often worse with movement
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Swelling around the injured area
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Bruising or discoloration of the skin
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Tenderness when touching the affected bone
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Reduced movement or difficulty using the hand
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Deformity, such as a finger appearing bent or rotated
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Weakness when gripping objects
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In some cases, numbness or tingling, particularly if nearby nerves are affected
Rotational deformity, where a finger crosses over another when making a fist, may occur in some fractures and can significantly affect hand function if not corrected.
Diagnosis & Investigation
Hand fractures are diagnosed based on clinical history and physical examination, supported by imaging.
During your visit:
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The surgeon will ask about how the injury occurred, the timing of symptoms, and any previous hand injuries.
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A physical examination will assess swelling, tenderness, deformity, and finger alignment.
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The surgeon will check movement, stability, and circulation to the fingers.
Imaging
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X-rays are usually required to confirm the diagnosis and determine the position and severity of the fracture.
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In rare cases, additional imaging such as CT scans may be used to assess complex fractures or joint involvement.
Non-Surgical Treatment
Many hand fractures can be treated without surgery, particularly if the bones remain well aligned.
Non-surgical treatment options may include:
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Splinting or casting to protect the fracture and allow it to heal
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Buddy strapping, where an injured finger is supported by taping it to a neighbouring finger
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Activity modification, avoiding heavy use of the injured hand
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Pain relief medication, such as paracetamol or anti-inflammatory medication
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Hand therapy, to maintain movement and prevent stiffness once healing has begun
Stable fractures often heal successfully with these measures.
Surgical Treatment
Surgery may be recommended if the fracture is displaced, unstable, involves a joint, or cannot be held in a satisfactory position with splinting alone.
Common surgical options include:
Manipulation Under Anaesthetic (MUA)
In some cases, the fracture can be realigned without making an incision. This is performed under local or general anaesthetic, allowing the surgeon to carefully reposition the bones into the correct alignment. The hand is then immobilised using a splint or cast to maintain the corrected position during healing.
Fracture Fixation with Pins (K-wires)
Thin metal wires (Kirschner wires or K-wires) may be used to hold the bones in the correct position while they heal. This is often performed following manipulation of the fracture to maintain alignment. The wires are usually removed once healing has occurred.
Plate and Screw Fixation
In more complex fractures, small plates and screws may be used to stabilise the bone and restore alignment. This provides stable fixation and may allow earlier movement in certain cases.
External Fixation
In certain injuries, particularly crush injuries or open fractures, an external fixator may be used to stabilise the bones while the surrounding tissues heal.
The choice of surgical technique depends on the type of fracture, its location, and the functional demands placed on the hand.
Recovery
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Recovery following a hand fracture depends on the type of fracture and whether surgery is required.
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Most fractures take 4–6 weeks to heal sufficiently.
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Hand therapy is often recommended to restore movement, strength, and function.
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Stiffness is common following hand fractures, and early guided movement is important once safe to begin.
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Recovery times vary depending on treatment:
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Simple fractures treated with splints may recover more quickly.
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Manipulation under anaesthetic is usually followed by immobilisation in a splint or cast while the fracture heals.
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Fractures treated with K-wires typically require a period of immobilisation followed by therapy.
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Plate and screw fixation may allow earlier movement but still requires structured rehabilitation.
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Full recovery of strength and function may take several months, particularly after more complex injuries.
Risks
Although treatment of hand fractures is usually successful, complications can occur, including:
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Infection
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Stiffness or reduced range of motion
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Malunion (healing in an incorrect position)
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Non-union (failure of the fracture to heal)
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Tendon or nerve injury
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Persistent pain or weakness
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Hardware irritation (in surgical cases)
Early treatment and appropriate rehabilitation help reduce the risk of complications.
When to See One of Our Hand Specialists
When to See One of Our Hand Specialists
You should consult a hand specialist if:
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You have sustained an injury to your hand and have pain, swelling, or deformity
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You are unable to move your fingers normally
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Your finger appears bent, rotated, or shortened
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Symptoms are not improving after initial treatment
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You have ongoing pain or reduced function following a previous hand injury
If you have an open wound associated with a fracture, a severe injury, or significant deformity, this should be assessed urgently in the Emergency Department (A&E).
