Of all the places to break a bone, our hand may feel like one of the most inconvenient, especially when it is your dominant hand. Whether you injure a finger or the bones in your palm, a broken hand can render you unable to perform normal daily tasks or even keep you from working. And when the bone is healed, you may need to continue seeking care and physical therapy services to regain the dexterity expected of a hand. If you are wondering how long this process takes, your provider will be able to give you a specific answer, but some general guidance is below.
Anatomy of a Broken Hand
Normally when we refer to a broken bone, we are talking about a specific bone, such as breaking your wrist or your collarbone. The hand is actually made up of 27 bones, most of them small, which are interconnected. There are two main categories of bones in your hand:
- Phalanges: The small bones that form your thumb and fingers. The thumb has two phalanges, and each finger has three, separated by the knuckles.
- Metacarpals: The five bones that compose the palm of your hand.
While the metacarpals are the thicker of the bones, they are more likely to be injured because we place most of our pressure on our palms. The fifth metacarpal, which supports the pinky finger, is the most commonly broken. Commonly known as a “boxer’s fracture,” this break occurs next to the knuckle joint.
To be diagnosed as broken, at least one of the bones in the hand must be affected. It can be broken into multiple pieces, or multiple bones can be impacted. While some people think that a fracture is different than a break, they are the same and can both occur in the hand bones. There are varying levels of fractures that can occur, such as:
- A stable fracture, where the bone is damaged but the pieces remain aligned
- An unstable fracture, where the bone fragments have shifted
- Comminuted fracture, in which the bone is shattered into many pieces
- Open or compound fracture, when a bone fragment breaks through the skin
When the hand is in pain due to a break to any bone, it will need medical attention.
How to Tell if Your Hand Is Broken
The symptoms of a broken hand may depend on the type of fracture and how severe it is. The most common symptoms include:
- Severe pain
- Trouble moving fingers
- Stiff or numb fingers
- Pain that worsens with movement and gripping
- Crooked fingers
- An audible snap during injury
Many people confuse a broken hand with a sprained hand. The latter does not impact the bones but the ligament that surrounds the bone and connects the pieces of each joint. The symptoms of a sprain can be similar, such as pain and bruising, even though the source of the injury is different. You are more likely to be able to move your hand, even if it is painful, with a sprain.
Common Causes of a Broken Hand
Unless there is an underlying medical condition, like osteoporosis, that weakens the bones, fractures will only occur in response to physical trauma that places extreme force on the bones. Any crushing or twisting of the hand, direct blows from an object, or heavy force and impact can cause a broken bone.
Some common accidents that can affect your hand are car accidents, falls, contact sports, physical fights, and anything machine-related. The most common form of the injury is the boxer’s fracture, which is usually caused by punching an object or person without properly protecting the hand.
Treating a Broken Hand Immediately
Any broken bone, including those in the hand, requires medical attention as soon as possible. Until you are able to reach a doctor or receive professional care, there are steps that can be taken to care for the hand and protect it from further injury. Taking the proper precautions at the time of injury can improve recovery times and minimize symptoms.
The three most important things you can do if you suspect a broken hand are:
- Apply light pressure to stop any bleeding.
- Avoid moving the hand, immobilizing it as possible. If you can see that a bone has moved out of place, do not attempt to realign it.
- Apply ice to reduce pain and swelling. An ice pack or cold compress can be used, wrapped in a cloth or towel to prevent direct contact.
These steps are meant to be a holdover until you can see a doctor, but you should not use them to extend this time period. Seek care as soon as possible, especially if there is a protruding bone or you experience numbness.
Will Broken Hands Heal on Their Own?
A broken bone can heal by itself in that the bones can grow back together if they are still touching or aligned, but the healing will likely not be correct. The bones may not line up properly, causing something known as a malunion. In the hand specifically, a malunion can interfere with your normal hand function and make daily activities difficult.
When bones grow together out of alignment, the only way to remedy this is through surgery which extends the healing process.
Diagnosing Broken Hands
To determine whether a hand is broken, the doctor you are seeing will first perform a physical examination, checking for visible signs of damage like swelling and bruising. In addition to your hand, they may also look at the wrist and arm to determine the severity of your injury.
You should also expect to be asked about your medical history, including any past hand injuries or conditions like osteoporosis. It will also be important for the doctor to understand the circumstances surrounding your injury so they can determine if you may have other injuries or how the hand may have been impacted.
An x-ray is almost always used during the diagnosis of a broken hand to rule out other issues and confirm that there is a break. In addition to validating that there is a break, this scan allows the doctor to identify the location, type, direction, and severity of the break.
Broken Hand Treatment Methods
The goal of any treatment plan is to help the bone heal correctly, allowing your hand to eventually return to its normal strength and dexterity.
The most common form of treatment is a cast, splint, or brace, which immobilizes the hand and promotes proper healing. The bones will be lined up correctly before being placed into the cast, splint, or brace- which one is used will depend on your specific injury. These are best used for phalange breaks, as metacarpal fractures are difficult to fully immobilize.
During healing, you may be prescribed pain medication to both minimize pain and reduce swelling. If the area is swollen at the time the bone is set, it may cause improper alignment, so it is important to manage this symptom. Doctors will advise as to whether you need prescription medication or can rely on over-the-counter options like Tylenol, as well as providing dose and frequency instructions.
Surgery is not required for most broken hands, but severe injuries may require it. Open fractures, bones that are completely crushed, loose bone fragments, and breaks extending to the joint are all common reasons that surgery may be performed. You may also need to have a bone graft completed or use metal screws and pins to keep the bones in place. Surgery can also be recommended if the bone becomes rotated, as this can rotate your fingers and severely limit hand function.
Average Recovery Times for Broken Hands
As a general rule, a broken hand will take between 3 to 6 weeks to heal when a cast, splint, or brace is placed. However, this can depend heavily on factors like your bone health, the exact location and type of the break, and the severity of the injury. Surgery will usually increase this time.
Around 3 weeks after the original injury, your doctor may have you begin gentle hand therapy to help regain strength and decrease the stiffness in your hand. If the hand is immobilized for too long, you can begin to lose function, so therapy is important to introduce early. Some early therapy can be performed while still in a cast, and you may be told to continue once it has been removed.
You may undergo multiple x-rays throughout the process of healing to help monitor your progress. This helps the doctor to determine when it’s safe to return to normal activities and discontinue treatment.
Exercises for Injured Hands
As you are healing from a broken hand, you should always work with a licensed physical therapist to determine the right plan for you. These are some sample exercises that can be used to maintain strength and flexibility in your hand after an injury.
- Making fists. This one is as easy as it sounds. Begin with your hand in a stretched position, then slowly make a fist before returning to the original stretch. Repeat as many times as needed.
- Finger stretches. Begin with your hand relaxed on a flat surface, then slowly straighten your fingers. Hold this position for about one minute before relaxing and switching hands.
- Finger lifts. To improve flexibility, place your hand flat on a surface and gently lift each finger one at a time. Repeat about 10 times on each hand.
- Thumb touches. Hold your hand in an upright position. Slowly bring each finger to touch your thumb, one at a time. Repeat on your other hand.
- Claw stretches. Face your palm away from you, then move your fingers so your hand resembles a claw. Hold the position for one minute before repeating on the other hand.
- Grip strengthening. Use a stress ball or grip strengthening ball, holding it as tightly as possible and releasing 10 to 15 times with each hand.
- Pinch strengthening. Pinch a soft foam ball between the tips of your thumb and another finger for about one minute. Switch to another finger and repeat up to 15 times for each finger.
- Wrist extensions. Use a folded towel or similarly tall object to place your wrist on, letting your hand hang over the edge. Move your hand up and down, with your palm facing up. Repeat with your palm facing down.
- Wrist movement. Place your wrist on a folded towel or similarly sized object. Point your thumb up like you are giving a thumbs up, then wave your hand up and down through a full range of motion. Repeat on each size.
- Wrist rotating. While standing or sitting, keep your elbows at a 90-degree angle. Place your palms up, then down, then to the sides to rotate your arms.
- Thumb extensions. Move your thumb to the center of your palm, then to its normal position, repeating up to 10 times.
- Tendon gliding. Begin with your hand in a flat position, then move it to any other position, such as a hook fist, a full fist, or a straight fist. Return to a flat position.
These exercises can be useful for anyone, whether you have suffered a broken hand or not. During the course of physical therapy, your provider may use some of these in your program, while others may not be recommended. Once you have returned to normal function, you can incorporate these exercises into your daily life to help avoid future injury and maintain progress. If any of these causes you pain in the aftermath of a broken hand, return to your provider.
Whether you have just broken your hand or need to treat lingering injuries, the physical therapists at AICA Jonesboro will be ready to help you. Along with our other specialists, your physical therapist will create a customized plan based on your injury and your goals for healing. We strive to effectively communicate the timeline for your plan and be transparent with any changes based on how your body responds to treatment. To get started, contact AICA Jonesboro for your first consultation today.