How to tell if you have a broken hand

Leading consultant orthopaedic surgeon, Mr Andrew Logan, specialises in hand and wrist surgery. He gave us some of the answers to your FAQs on broken hands, fractures and treatment.
 

We recently spoke to him about the importance of diagnosing a fracture early, how long it takes for a broken hand to heal and whether you can tell if it’s broken without an x-ray.
 

How can I tell if I broke my hand?

The simple answer is, that in most cases, you cannot. The signs of a broken bone in hand are pain/tenderness, swelling, bruising with or without deformity. Apart from an obvious deformity you can get the same signs with a non-bony injury such as ligament sprain or skin and muscle bruising.

How many different types of hand fractures are there?

In the hand there are wrist bones (carpals), hand bones (metacarpals) and finger bones (phalanges). The fracture can be in the middle of the bone or can involve the joint where one bone meets and moves against another. The fracture can cause the bone to move out of position (a displaced fracture) or remain in its normal position (an un-displaced fracture). A fracture can be stable meaning that it is unlikely to move out of position or unstable where the fracture can move further. There are therefore a significant number of variations of hand fracture types.
 

What should I do if I suspect my hand is broken?

Attend your local Accident and Emergency department that same day if possible. If you cannot, then attend the following day. It is important that you get an x-ray.

How are hand fractures treated?

Most fractures in the hand can be treated without operation. The method of treatment depends on the type and location of the fracture. Some fractures are treated in a plaster cast, some with a moulded plastic splint and some with just finger strapping.

Some fractures do need an operation to put the fractured bone back into the correct position and then hold that position. The commonest way of operating on a hand fracture is either to fix it with a small plate and screws or with a wire.
 

Why is it important to diagnose the fracture early?

When a hand bone is first broken each side of the fracture is like a piece of jigsaw that matches together. The pieces are also mobile and can be moved easily into place. As healing takes place new bone is formed that stops the fracture from moving and the pieces become less easy to match together.
 

If the fracture does need an operation it is much easier to fix the fracture as soon as possible after the injury. If too much healing has already taken place and the fracture is in the wrong position then it can be too late to do an operation to correct this position. This is especially so if the fracture involves the surface of a joint.
 

Can a fracture heal without treatment?

Most fractures do heal without operative treatment. The hand is very mobile and it is important that the fingers and wrist do not stiffen after an injury. Fractures of the finger and hand bones can cause finger stiffness after fracture healing. With fractures in those areas, hand therapy is often started, even before the fracture has fully healed.

What does the broken hand healing timeframe look like?

I look at the healing timeframe in terms of ability to use the hand. The ability to use the hand after a hand fracture depends on the bone broken and the fracture pattern. A significant number of hand fractures allow the patient to use the hand as pain allows but this would usually only be for very light activity initially. As time progresses the hand can gradually be used for an increasing number of activities with less pain. Some hand fractures will prevent the hand from being used for up to six weeks after the fracture.
 

In most cases there will be near normal hand use, with return to pre-accident activities, by six weeks after the fracture.
 

Book an appointment with Mr Andrew Logan today via his Top Doctor's profile here if you feel you will require an expert’s opinion on your hand or wrist pain.