Section 5. Bone, Joint, and Muscle Disorders

Chapter 62. Fractures

Topics: Introduction | Foot Fractures | Leg Fractures | Hip Fractures | Fractures of the Pelvis | Fractures of the Spinal Column | Shoulder Fractures | Arm Fractures | Hand Fractures

Hand Fractures

Hand fractures involve the bones of the wrist (carpals), palm (metacarpals), or fingers and thumb (phalanges). However, normal hand function is the result of a complex interaction of an intricate arrangement of muscles, tendons, ligaments, and joints, as well as bones. Thus, seemingly minor fractures can cause serious soft tissue injuries that, if not treated properly, can lead to disabling stiffness, weakness, or deformity.

Fractures of the ends of the 4th and 5th metacarpals commonly occur from punching a hard object. This type of fracture, called a boxer's fracture, causes swelling and tenderness of the knuckle. Most of these fractures are treated with a cast, after a reduction if the fracture is badly angled. Typically good function of the finger returns.

Avulsion fractures at the site of tendon and joint capsule attachments occur commonly in the fingers. A mallet finger injury refers to the drooping of the fingertip that occurs when the tendon that extends the finger becomes detached (see Section 5, Chapter 71). Simple mallet finger injuries can respond to splinting the finger straight for 6 weeks, but those with serious tendon or bone injuries may require surgery. Other less common fractures of the hand include fractures of the scaphoid bone (see Section 5, Chapter 71) and the tuft of the fingertip.