Hand fractures

When to seek urgent help

Seek prompt medical assessment after a suspected fracture. An open wound over a fracture, a visibly deformed finger, loss of sensation, a cold or pale finger, or severe increasing pain needs urgent attention. Attend an emergency department for a serious injury; call 000 for an emergency.

Remove rings early if this can be done safely before swelling increases. Do not try to straighten a deformed finger yourself.

Assessment and treatment choices

Assessment includes the injury mechanism, skin and wounds, finger rotation, movement, tendon function, sensation and circulation. X-rays are commonly required; further imaging is sometimes needed.

A stable fracture in an acceptable position may be managed with a splint, cast or support to an adjacent finger. A displaced fracture may need manipulation to restore alignment. Joint involvement, rotation, instability or associated injuries can make surgery more appropriate.

Fracture fixation

Surgery may use wires, screws or plates to hold the bone while it heals. The choice depends on the fracture pattern, soft tissues and rehabilitation plan. Open injuries may also need wound cleaning and treatment of damaged structures.

Local, regional or general anaesthesia may be appropriate depending on the operation. The hospital setting, admission and follow-up arrangements are confirmed individually. Hardware is not always removed; temporary wires or problematic implants may require later removal.

Recovery and hand therapy

Healing bone needs protection, but prolonged immobility can cause stiffness. The timing of movement and loading must therefore match the stability of the injury and fixation. A hand therapist may help with splinting, swelling, exercises and gradual use.

Return to work depends on which hand is injured, your tasks and whether you can work safely with restrictions. Heavy lifting, contact sport and driving may need to wait. Follow your plan rather than testing the hand before it is ready.

Scars, risks and limitations

Surgery leaves scars and can cause stiffness, tendon irritation or altered sensation. Risks include infection, bleeding, poor alignment or rotation, delayed healing or failure to unite, joint damage, persistent pain, hardware problems and further surgery. Complex regional pain syndrome is an uncommon but important possible complication.

A fracture involving a joint can lead to later arthritis. Even with treatment, full movement or previous strength may not return. Seek advice for worsening pain, numbness, colour change, excessive swelling, fever or a splint that feels too tight.

Frequently asked questions

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