A hand fracture or a broken wrist is a break or crack in one of the many bones within your wrist and hand. The most common of these injuries occurs in the wrist when people try to catch themselves during a fall and land hard on an outstretched hand.
Risk factors for a broken wrist or broken hand range from participation in certain sports — such as American football, soccer, skiing or snowboarding — to having osteoporosis, a condition in which bones become thinner and more fragile.
It’s important to treat a broken wrist or broken hand as soon as possible. Otherwise, the bones may not heal in proper alignment, which can affect your ability to perform everyday activities, such as grasping a pen or buttoning a shirt. Early treatment will also help minimize pain and stiffness.
Symptoms of Hand Fractures
Some signs of broken bones are clear – for example, when the bone breaks through the skin in an open fracture. Other signs that bones may be broken and growth plates injured include:
• Severe pain
• Swelling, bruising or bleeding
• Bone or joint that looks out of place or the wrong shape
• Weakness, numbness or tingling
• Trouble moving the part of the body that is broken
When your child or teen breaks a bone, they will have pain at the site of the break. It will be hard for them to move the body part that is broken. This pain and loss of movement is your cue to take them to the doctor or the emergency room.
What causes a hand fracture?
A hand fracture is often cause by an injury. Car and sports accidents are common causes. A fall on your hand or a direct blow caused by sports, such as boxing, may cause a hand fracture. Stress fractures may happen from repetitive or overuse. Softball and tennis are common causes of stress fractures.
Diagnosis of Hand Fractures
First, Dr Yip will examine your child. During the exam, the doctor checks how the bones line up when your child moves their hand, if they can, and when the doctor tries to move it. The doctor also looks for related injuries, like damage to the fingernail, tissue under the nail (nail bed), ligaments, tendons or joints.
If one or more bones might be fractured, your child will need X-rays. This helps us know how to treat your child. Most likely your child will have X-rays from three angles so the doctor can see clearly where the break or breaks are.
Careful diagnosis is important. Simpler breaks can be treated with a splint or a cast. More complex breaks may require surgery. Knowing when a child’s fracture needs surgery requires special education and experience with pediatric trauma.
If the bone is broken at or near a growth plate, the doctor may suspect the growth plate is injured. The growth plate itself can’t be seen on an X-ray, but some signs of damage may show up. Sometimes children need an MRI (magnetic resonance imaging) scan or other scan to check for growth-plate damage.
Treatment of a Hand Fracture
• Brace, cast, or splint: A brace, cast, or splint may be used to decrease your hand movement. These work to hold the broken bones in place, decrease pain, and prevent further damage to your hand.
• Finger strapping: If you have a broken finger, your broken finger may be strapped or taped to the finger next to it. This can provide support, limit motion, and decrease stiffness.
o Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.
o Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
o Tetanus shot: This is a shot of medicine to prevent you from getting tetanus. You may need this if you have breaks in your skin from your injury. You should have a tetanus shot if you have not had one in the past 5 to 10 years.
• Surgery: If you have an open fracture, you may need debridement before your surgery. This is when your caregiver removes damaged and infected tissue and cleans your wound. Debridement is done to help prevent infection and improve healing.
o External fixation: In this surgery, screws may be put through your skin and into your broken bones. The screws will be secured to a device outside of your hand. External fixation holds your bones together so they can heal. It is often done if you have severe tissue damage or many injuries.
o Open reduction and internal fixation: Your caregiver will make an incision in your hand to straighten your broken bones. He will use screws and a metal plate, nails, or wires to hold your broken bones together. This surgery will allow your bones to grow back together.
o Pin fixation: With this surgery, metal pins will be used to straighten the broken bones in your hand. The pins will hold the broken pieces of bone together. Your caregiver will place the pins through your skin and into your bone using a small drill.
What are the risks of a hand fracture?
• You may have numbness or weakness in your hand from surgery. After surgery, you may have pain, tightness, or your hand may not work as well as it did before your injury. Screws, nails, or pins used during your surgery may come loose, and you may need another surgery. You may get an infection. You may get a blood clot in your arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.
• Without treatment, your broken hand may not heal. If your fracture heals on its own, your hand may be deformed. You may not be able to move your hand as well as you did before your injury. You may have pain and weakness in your hand. You also may lose feeling in your hand. You may have tissue damage, and you may get an infection.
What can I do to help my hand heal?
• Rest: You may need to rest your hand and avoid activities that cause pain.
• Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your hand for 15 to 20 minutes every hour as directed.
• Elevate your hand: Raise your hand above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your hand on pillows or blankets to keep it elevated comfortably.
• Physical therapy: A physical therapist teaches you exercises to help improve movement and strength and to decrease pain.
When should I contact my caregiver?
Contact your caregiver if:
• You have a fever.
• You have new sores around your brace, cast, or splint.
• You have new or worsening trouble moving your hand.
• You notice a bad smell coming from under your cast.
• You have questions or concerns about your condition or care.
When should I seek immediate care?
Seek care immediately or call 911 if:
• The pain in your injured hand gets worse, even after you rest and take pain medicine.
• You have drainage from your surgery wounds or open skin areas.
• Your surgery wound or open skin areas become red, warm, and swollen.
• Your injured hand or fingers feel numb.
• The skin or fingers on your injured hand become swollen, cold, white, or blue.
• Your cast cracks or gets damaged.
• Your arm feels warm, tender, and painful. It may look swollen and red.
• You suddenly feel lightheaded and short of breath.
• You have chest pain when you take a deep breath or cough. You may cough up blood.