Finger Fracture

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There are five fingers (also known as digits) attached to the human hand. The four fingers can be folded over the palm which allows the grasping of items. Each finger, beginning with the nearest to the thumb, has a name to distinguish it from the rest, which are the index finger, middle finger, ring finger, and little finger.

The thumb is located on one of the sides, parallel to the arm. A reliable way of identifying and hands is from the presence of opposable thumbs. Opposable thumbs are identified by the ability to be brought opposite to the fingers; a muscle action known as opposition.

Generally, fingers are made of 14 small bones called phalanges (phalanx for a single small bone). When a finger is fractured, one or more of the phalanges are affected. This is referred to as a finger fracture. Although fingers are a small part of the human anatomy, a fractured finger is not a minor injury. In a non-injured finger, the bones are aligned precisely for ease of movement such as gripping, grasping, and manipulating tiny objects. When one or more of the bones are damaged, it can affect the function of the entire hand, causing pain, stiffness, and loss of movement. Without treatment, a finger fracture can cause problems including prolonged stiffness and pain.

 

Causes & Symptoms of Finger Fracture

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Most finger fractures occur as a result of trying to break a fall or pushing away from an object. Your fingers are commonly the first part of your body to come in contact with a wall, floor, or other objects that can cause injury. Finger fractures also happen as a result of crush injuries. Additionally, finger fractures can occur as the result of rotational or twisting injuries to the digit.

Sometimes, a fracture may occur as a result of abnormal bone within the finger – this type of fracture is called a pathologic fracture and is the result of having a condition that causes weakening of the bone leading to susceptibility to fracture.

Common causes of pathologic fractures in the finger include tumors, infections, and osteoporosis. Signs of a fractured finger include:

 

  • Pain when touching the affected finger

 

  • Swelling of the finger

 

  • Bruising

 

  • Difficulty bending the injured finger

 

  • Deformity

 

Other significant problems of the fingers can have similar symptoms, including infections, dislocation, and tendon injuries. Therefore, it is always important that you have an injury evaluated as soon as possible.

Who gets Finger Fracture?

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People with weak bones, such as older adults or those with a calcium deficiency, have a higher risk of experiencing a finger fracture. Also, people who work with their hands, such as athletes and manual laborers, have an increased risk of finger fractures. In severe cases, high-impact events, such as car accidents, can also cause finger fractures.

Sports that increase this risk include:

 

  • Basketball
  • Baseball
  • Hockey
  • Wrestling
  • Skiing
  • Snowboarding

How Does It Affect You? How Serious Is It?

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If you fracture or even break a finger, there are a few levels of severity that will determine what approach your doctor chooses to take. If you have a stable, non-displaced fracture, this means you may have a crack in the bone, but the bones are still in the right place. A stable fracture is the simplest type of fracture to fix and typically requires stabilization and immobilization.

A spiral fracture or shatter can be much more complicated and problematic when it comes to fractures in general. A spiral fracture occurs when the bone breaks with a twisting motion. It often separates into two parts, with the edges no longer aligned. Other more complicated fractures include a crack at the knuckle and damage to the ligament around the bone.

Another frequent finger injury is the pinkie break, sometimes called a boxer’s fracture. The boxer’s fracture is actually an injury to the metacarpal bone of the hand, just below the bottom joint of the pinkie finger. Another complication that is associated with finger fractures is arthritis. There are three different types of finger arthritis that can take place after a finger fracture, including the following:

 

Osteoarthritis

Also called wear-and-tear arthritis, is the most common type of finger arthritis. Osteoarthritis causes normal cartilage to wear away. This exposes bare bones at the joints. The most frequently affected joints in the hand are the knuckles of the mid-finger and fingertip (PIP and DIP joints) and the joint at the base of the thumb.

 

Rheumatoid arthritis

This condition causes a different type of joint impact. Rheumatoid arthritis is an autoimmune condition that affects the entire body. It causes the immune system to attack the soft tissues surrounding the joints. The most commonly affected joints in the hand are the knuckles at the base of the fingers (MCP joints).

 

Gout

This is a condition that happens when crystals develop within the joints. These crystals can form in one or more joints when there is too much of a substance called uric acid in the body. While the big toe is the most commonly affected part of the body, gout can also develop in finger joints.

Recommended Treatment, Rehabilitation & Supporting Equipment

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If you have symptoms of a fractured finger, your doctor will most likely obtain an X-ray to help determine if there is a fracture. Not all fractures show up accurately on a single X-ray, so it may be required to obtain multiple X-rays in different angles if the diagnosis isn’t clear.

Examination of the injured finger is very helpful to guide treatment. An examination can help determine if there is a shortening or rotation of the digit as a result of the injury. An examination can also be helpful to ensure there is no tendon damage or other injury that could alter the treatment recommendations.

If the fracture involves a joint, it is important to ensure that the joint surfaces line up well. On the X-ray, your doctor will examine the joints of the fingers, and make sure there is no irregularity of the joint surface.

Secondly, it is very important to know if the fracture is stable or unstable. To determine the stability of a fracture, your doctor will look at the pattern of the break on an X-ray to predict if the fracture will tend to slip out of position over time or stay in a stable position.

Lastly, your doctor will search for deformities of the finger such as shortening and rotation. Your fingers on the injured hand should line up the same way as the fingers on your uninjured hand. This means if you straighten out all your fingers on both hands, they should come to the same comparable length. Also, when you make a fist, your fingers should not cross, they should line up parallel to each other. Crossing of the fingers while making a fist is an indication that there may be a rotational deformity caused by the fracture.

If the joint surfaces do not line up well, if the fracture is unstable, or if there is a deformity that needs correction, surgery may be required to allow for optimal function after healing of the injury.

The first critical treatment step for any finger injury is immobilization. You need to keep the finger in place to allow it to recover. Your doctor may recommend a cast or splint depending on where and how severe the fracture is. For a stable fracture, a simple splint may help immobilize the fractured finger.

There are also specialized splints available for fingertip and thumb injuries. In some cases, your doctor may recommend a cast up to the elbow to protect the finger and let it heal, even for stable breaks.

Depending on the type of severity of the fracture, you may need surgery to put the bones into alignment. Small devices, such as pins, screws, or wires, will be used to help hold your fractured bones together.

After reduction, immobilization, and 4-6 weeks of healing, the prognosis for the bones coming together and healing properly is excellent for a fractured / broken finger. The most common problem encountered after treatment of fractures in the fingers is joint stiffness. By immobilizing the fingers, the capsule, and surrounding tissue from scar tissue around the joint; it becomes a race to properly heal the bone before the joint becomes too stiff and a decrease in motion occurs.

Many patients may require physiotherapy for range of motion exercises. Stiffness and swelling are of great concern and may be long-term reminders of the injury.

Here are some examples of typical rehabilitation exercises for finger fractures:

 

Finger extension

First, place your hand flat on a table, palm down. Then, lift and lower your affected finger off the table. Repeat this exercise 8-12 times a day.

 

MP extension

Place your good hand on a table, palm up. Next, put your hand with the affected finger on top of your good hand with your fingers wrapped around the thumb of your good hand like you are making a fist. Slowly uncurl the joints of your hand with the affected finger where your fingers connect to your hand so that only the top two joints of your fingers are bent. Afterwards, move back to your starting position with your fingers wrapped around your good thumb. Repeat this method 8-12 times a day.

 

DIP flexion

With your unaffected hand, grasp your affected finger. Your thumb will be on the top side of your finger just below the joint that is closest to your fingernail. Slowly bend your affected finger only at the joint closest to your fingernail. Hold this position for 6 seconds before repeating 8-12 times a day.

 

PIP extension

Place your good hand on a table, palm up. Then, put your hand with the affected finger on top of your good hand. Use the thumb and fingers of your good hand to grasp below the middle joint of your affected finger. Finally, bend and then straighten the last two joints of your affected finger. Repeat this exercise 8-12 times a day.

 

Imaginary ball squeeze

Pretend that you’re holding an imaginary ball. Slowly bend your fingers around the imaginary ball and squeeze the ball for 6 seconds. Then, slowly straighten your fingers back to the starting position as if you are releasing the imaginary ball. Repeat this method 8-12 times a day.

 

Towel squeeze

Place a small towel roll on a table. With your palm facing down, grab the towel and squeeze it for about 6 seconds. Finally, slowly straighten your fingers to release the towel. Repeat this exercise 8-10 times a day.

 

Towel grab

Begin by folding a small towel in half, then lay it flat on a table. Next, put your hand flat on the towel, palm down. Grab the towel and scrunch it toward you until your hand is in a fist. Slowly straighten your fingers to push the towel back so it is flat on the table. Repeat this exercise 8-12 times a day.

Alternative & Homeopathic Treatment

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Once a cast or splint has been applied to your fractured finger, you will likely still feel pain for at least a few days. Usually, OTC (over-the-counter) pain relievers are enough to cure pain, including non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. Here are other homeopathic treatments to help reduce a finger fracture:

 

Elevation

Keep your hand elevated above the level of your heart as much as possible. Elevation helps reduce swelling, therefore, the more your finger is swollen, the more time it will take to heal once it is elevated.

 

Ice application

If you have a splint that allows you to feel ice, consider applying an ice pack to your fingers a few times a day for 20 minutes at a time for the first few days after the fracture. This will help reduce further swelling.