Hand fractures are injuries that can occur during everyday activities, sports, household work, or industrial accidents. Because the hand is one of the most exposed and important organs of the human body, it is particularly prone to injuries.
From playing cricket and other sports to working with machines, handling metal or glass, or performing routine kitchen activities, hand injuries can happen in many different situations. Understanding how hand fractures differ from other fractures and recognizing the warning signs can help ensure timely medical attention.
What Are the Common Causes of Hand Fractures?
The commonest causes of hand fractures include accidents, sports injuries, domestic injuries, and industrial accidents. Sports injuries are particularly common in adults, especially while playing cricket or participating in outdoor activities.
Industrial injuries can occur in people or labourers working with machines, metal, or glass. In women, domestic and kitchen injuries are also common, such as injuries while cutting vegetables or while operating a mixer or grinder machine.
In a nutshell, sports injuries in adults, machine injuries in people working in industries, and household or kitchen injuries are some of the common causes of hand fractures.
Why Is the Treatment of Hand Fractures Different?
Hand fractures are different from fractures involving areas such as the thigh, arm, or forearm. In these areas, there is a considerable amount of muscle, skin, and soft tissue around the bone. In the hand, there is very less muscle and the structure is very slender.
Because of this, hand fractures can be difficult to treat. If a hand fracture is not treated properly, one of the commonest problems a patient can develop is stiffness of the hand.
Immobilization is also different. For example, when somebody gets a fracture around the elbow, a cardboard or wooden plank can be used to provide support. In the hand, there is very little available space to protect the injured area.
The hand is also one of the most exposed organs of the human body. As a result, open injuries and crush injuries are extremely common.
Why Can One Fracture Affect the Function of the Hand?
A single finger has three joints. Because of this, one fracture can result in stiffness of one finger, and a stiff finger can affect the entire function of the hand.
If a fracture occurs around a joint and is not treated properly, the resulting stiffness can affect the movement of the other fingers as well. This is one of the important reasons why hand fractures require careful assessment and treatment.
What Is the Primary Treatment for a Hand Injury?
The initial treatment depends on whether the injury is closed or open. If the injury is a closed injury, meaning there is no open wound, an ice pack can be applied to the injured area.
For an injury to the finger, a simple support such as an ice cream stick can be placed over the finger and secured with a band-aid. If there is an injury to another part of the hand, a newspaper can be used as a temporary support and wrapped with a dupatta or crepe bandage.
Anything wrapped around the hand should not be made very tight because this can stop or reduce the blood supply to the finger.
How Does a Splint Help?
For injuries occurring on the field or during sports and other outdoor activities, a ready-made splint can be used. A splint is a ready-made support with a Velcro strap that helps immobilize the injured area.
If a splint or other support is not available, the patient can keep the hand on the shoulder and rest it in this position. Keeping the hand elevated is a way to immobilize it and provide primary treatment.
The purpose of keeping the hand elevated is to help reduce swelling and allow any swelling or bleeding to move down and settle.
Do All Hand Fractures Require Surgery?
No, not all hand fractures require surgery. The treatment depends on the location and nature of the fracture.
When a fracture occurs at a joint, surgery may be required because early movement is important. If the fracture is at the shaft level or away from the joint, simple taping of two fingers with a strap or band-aid may be sufficient.
However, an open injury or crush injury requires particular attention. If important nerves or tendons responsible for movement are involved, surgery may be required.
What Is Malrotation?
Some hand fractures may be described as hairline fractures or very mild fractures. However, one important thing to check after a hand fracture is whether the patient is able to make a proper fist.
If the finger deviates to one side or the other while making a fist, this is called malrotation. Patients with malrotation may require surgery.
This is an important reason why the position and movement of the fingers should be assessed after a hand injury.
What Should You Do for an Open or Crush Injury?
When an open wound or bleeding occurs at home, some people try to apply turmeric or haldi, or other household remedies, to the injured finger. Some may also tightly bandage the finger or apply a lot of pressure to stop the bleeding.
Household remedies such as turmeric, haldi, or other kitchen-related products should not be applied to an open finger injury.
If the patient subsequently requires surgery, these substances can get stuck to the nerves, tendons, and bone so tightly that they become difficult for the surgeon to remove. This can cause more infection rather than helping to prevent it.
What Can Be Done Immediately After Hand Fracture?
If the bleeding is not very active, the hand can be held under tap water for around 30 seconds. This helps reduce the direct contamination and bacterial load.
An antiseptic ointment can then be applied and a very loose dressing can be used. The hand should also be kept elevated, which can help reduce the bleeding significantly.
What Are the Red Flags in Hand Fractures?
Many patients with a hand injury, particularly when the injury is closed and there is no bleeding wound, may not visit a doctor immediately. They may first check whether their fingers are moving and seek medical attention only when they realize that certain movements are not happening.
However, by that time, it may be too late. It is therefore important to reach out to a doctor within the first 48 hours and make sure that the injury has been properly assessed.
Change in the Colour of the Fingertip
The fingertip or pulp of the finger should normally look pink compared with the other hand or fingers. If the fingertip looks dusky, red, black, or green, the patient should reach out to a doctor.
This may indicate a problem with the blood vessel or that gangrene has started.
Loss of Sensation
Another important warning signal is a change in sensation at the fingertip. If the finger feels numb or there is not much sensation, the patient should reach out to a doctor immediately.
A simple way of checking sensation is to notice whether the finger has normal sensation when coming in contact with a cold water glass or a hot water cup.
Severe or Unbearable Pain
Another important warning signal is excruciating or unbearable pain. If the injury was not very serious but the pain is not subsiding even after taking a painkiller or tablet, the patient should visit a doctor as early as possible.
Pain that is unbearable or disproportionate to the injury should not be ignored. For example, a person may have a trivial fall or minor injury, but after two days the hand may become very swollen and the pain may become unbearable. This is a warning sign that requires medical attention.
Malrotation of the Finger
The last and most important sign in a fracture is malrotation. If the finger deviates to one side or the other while making a fist, it should be assessed by a doctor.
When Should You Seek Medical Attention?
A hand injury should not be ignored simply because the fingers are still moving. Early medical assessment is important, particularly when there is an open or crush injury, severe swelling, unbearable pain, a change in the colour of the fingertip, numbness or reduced sensation, or malrotation of the finger.
Hand fractures can be difficult to treat because of the structure and function of the hand. Appropriate assessment and timely treatment are important to prevent stiffness and to preserve the function of the hand.
Frequently Asked Questions (FAQs)
What are the common signs of a hand fracture?
Common signs include swelling, pain that does not settle, difficulty moving the fingers, and a finger that deviates to one side while making a fist (malrotation). Changes in fingertip colour or loss of sensation are red flags that need urgent medical attention.
Can I move my fingers if I have a hand fracture?
Yes, in some cases. Being able to move the fingers does not rule out a fracture, and many patients delay seeing a doctor for this reason. A hand injury should be assessed by a doctor within the first 48 hours.
What is the first aid for a hand fracture?
For a closed injury, apply an ice pack and support the hand with a simple splint, such as an ice cream stick for a finger or a folded newspaper wrapped with a crepe bandage for the hand. Do not wrap it tightly, and keep the hand elevated. If there is no splint, rest the hand on the opposite shoulder.
Do all hand fractures require surgery?
No. Fractures at the shaft level, away from the joint, may only need two fingers taped together. Surgery may be needed for fractures at a joint, malrotation, open or crush injuries, or when nerves or tendons are involved.
What is malrotation of the finger and why is it important?
Malrotation means the finger deviates to one side while making a fist. It can occur even with a mild or hairline fracture and may require surgery, so the finger should be assessed by a doctor.
Should I apply turmeric (haldi) on an open finger injury?
No. Turmeric and other kitchen remedies can stick to the nerves, tendons and bone, make removal difficult during surgery and increase the risk of infection. Hold the hand under tap water for about 30 seconds, apply an antiseptic ointment and use a very loose dressing.
What happens if a hand fracture is not treated properly?
The commonest problem is stiffness. Each finger has three joints, so one stiff finger can affect the movement of the other fingers and the function of the whole hand.
When should I see a hand surgeon after a hand injury?
See a doctor within 48 hours of any hand injury, and immediately if there is an open or crush injury, severe swelling, unbearable pain, a dusky, red, black or green fingertip, numbness, or malrotation.
Where can I get hand fracture treatment at Pinnacle Ortho Centre?
You can fix an appointment with the Hand Surgery department at Pinnacle Ortho Centre by calling 02240763000
To know more about the management of hand fractures and the treatment options available, fix an appointment with our Hand Surgery department at Pinnacle Ortho Centre.
This Blog post has been published for patient information purposes by Pinnacle Ortho Centre Hospital.
For more information, contact us 02240763000 / 7028859555.
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