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J. Theodore Schwartz, Jr., M.D.

Meet Dr. Schwartz

Orthopaedic Surgeon
  • Specializes in disorders of the Hand, Elbow & Shoulder
  • Harvard Fellowship trained
  • Shoulder Arthroscopy & Replacement
  • Carpal Tunnel & Nerve Surgery

Finger Fracture Fixation

The hand is made up of 27 bones that form the wrist, palm, and fingers. Fingers can easily injure from daily activities, and fractures are common injuries that can occur.   Injury to the metacarpal bone that connects to the little finger are the most common fractures, accounting for about one-third of all hand fractures. The fracture may be simple or involve a shift in the position of the bone or joint. There are also more severe fractures where the bone is crushed into many pieces.

Causes

Finger fractures occur most often from high impact trauma to the hand such as with  a fall, motor vehicle accident, sports activities, or a fist fight.

Signs and Symptoms

The common signs of a finger fracture include

  • Swelling and bruising around the fracture site
  • Pain and tenderness
  • Difficulty with finger movement
  • Deformity of the finger

Diagnosis

Finger fractures can be difficult to diagnose as the symptoms are similar to those of bone dislocation or sprain. Your physician diagnoses finger fracture after examining both the injured and uninjured fingers of the hand to see if they are of the same length. A fracture can also be detected when the injured finger overlaps with the others when you make a fist. An X-ray will be ordered to locate the injured area and confirm the diagnosis of a fracture.

Treatment

The treatment of a finger fracture begins with realigning the finger bone into the correct position usually under local anesthesia without cutting the skin. This is referred to as a closed reduction. 

A splint or plaster cast is then wrapped around the finger to support and protect it and keep it in the correct position while it heals. Your doctor may include the adjacent finger within the splint for additional support, a technique called buddy taping.

Surgery

If the fracture is severe, your surgeon will recommend surgery to repair the finger bones. An incision is made over the site of the fracture. Your surgeon will set the bones in correct alignment with instrumentation such as plates, pins or screws to hold the bones in place. Sometimes the bones may be severely shattered beyond repair. In such cases, your surgeon will use a bone graft to place new bone or bone substitutes into the spaces around the fracture. Once the repair is complete, the incision is closed, and the finger is placed in a cast.

Post-op care

You will be instructed on how to care for your cast.  For the first 2-3 days you should elevate the hand to decrease swelling and apply ice over the cast for 20 minutes at a time.

Do not smoke as smoking slows down or prevents bone healing.  If a bone graft was inserted, smoking can cause the graft to fail.

Once the cast is removed, your physical therapist will instruct you on rehabilitation exercises to reduce the stiffness and restore range of motion to the finger.

Risks and complications

The possible risks and complication associated with finger fracture surgery include:

  • Pain
  • Bleeding
  • Infection
  • Stiffness
  • Nonunion (bone fails to unite)
  • Malunion (Deformed union of the fractured bone)
  • Damage of the surrounding nerves or blood vessels