Hand Fractures

Your hands play an important role in interacting with the world around you. Breaking one of your hand bones can mean weeks (or longer) of learning new or different ways of navigating your routine. The bones in a normal hand line up precisely, letting you perform many specialized functions like grasping a pen or manipulating small objects in your palm. When you fracture a finger bone, it can put your whole hand out of alignment. Without treatment, your broken finger may stay stiff and painful. A delay in diagnosis and treatment can lead to poor healing, decreased range of motion, and decreased grip strength. For optimal results, you should see one of the highly respected and foremost-in-their-field hand specialists at the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado.

OVERVIEW

A “broken hand” is the same as a “hand fracture” – both terms refer to a break or crack in one or more bones within the hand; they are essentially the same thing, medically speaking. Hand fractures are some of the most commonly broken bones. Metacarpal fractures are especially common. One in 10 of all broken bones is a metacarpal fracture. They’re also the most common hand injury for people ages 18 to 34.

The metacarpal bones-also known as the “palm bones,” are the five long bones that make up the palm of the hand, situated between the wrist bones (carpals) and the finger bones (phalanges); they are numbered 1-5, with the first metacarpal belonging to the thumb and the fifth metacarpal belonging to the little finger. Anyone can break their hand, but some people are more likely to, including:

• People younger than 40.
• Athletes (especially people who play contact sports or practice martial arts).
• People with a health condition that affects their bones.

To be diagnosed as a hand fracture, one of the bones may be broken into multiple pieces or several bones may be affected. This is different from a sprained hand, which is the result of an injury to the muscle, tendon, or ligament.

ABOUT THE HANDS

About one-quarter of all the body’s bones are found in the hands. The human hand is a complex structure of bones, muscles, ligaments, tendons, nerves, blood vessels, and soft tissue that allows for a wide range of movement and dexterity. Ligaments are tough bands of connective tissue that support and keep bones in place. Important ligaments in the hand include the collateral ligaments, which prevent sideways movement of the finger and thumb joints. Tendons work with the bones to enable movement. Arteries: The radial artery runs along the radius bone, and the ulnar artery runs along the ulna bone. These arteries form arches in the hand that supply blood to the fingers. The radial nerve controls the position of the hand and stabilizes it. The palms and undersides of the fingers have ridges called fingerprints and palm prints that improve grip and tactile sensitivity.

There are 27 bones in each of the hands. Providers group them by their location and function:

• Carpals: The small bones that connect the hand to the wrist.
• Metacarpals: The five bones in the palm that give it its shape.
• Phalanges: The individual bones that make up the segments of the fingers and thumb.

With nineteen bones to look after regularly, it is not uncommon for many different types of fractures to occur, resulting in trauma to the hand. The most common age for a hand fracture in adults is 14 years for males and 13 years for females. Males have a higher risk of hand fractures than females, especially between the ages of 15 and 40. Elderly women are more likely to injure their hands than men, and falls are the most common cause of hand fractures in this age group.

WHAT IS A HAND FRACTURE?

There are well over 100 distinct types of hand fractures when accounting for all possible combinations of location, pattern, and characteristics. Some fractures are classified by the break’s shape or pattern. Some by how they happen. Some have their own unique name. The main types of hand fractures include:

1. Simple/Closed Fractures: The bone breaks but doesn’t pierce the skin. Common in metacarpals and phalanges.
2. Compound/Open Fractures: The bone breaks and penetrates through the skin, creating a risk of infection.
3. Comminuted Fractures: The bone breaks into three or more pieces. Often seen in crush injuries.
4. Spiral Fractures: A twisting injury causes the bone to break in a spiral pattern around the shaft.
5. Intra-articular Fractures: The break extends into a joint surface, potentially leading to arthritis if not adequately treated.
6. Avulsion Fractures: A small piece of bone is pulled off by a tendon or ligament.
7. Malunion: The bone heals in an incorrect position or alignment.
8. Stress Fractures: Tiny cracks that develop from repetitive stress, though these are less common in hand bones.

Some of the uniquely named fractures are:

9. Boxer’s Fracture: A break in the neck of the 5th metacarpal, usually from punching something such as a wall
10. Bennet’s Fracture: known as the 1st metacarpal fracture at the base of the thumb
11. Reverse Bennet’s Fracture: a 4th and 5th metacarpal fracture/dislocation
12. Rolando’s fracture: at the thumb base
13. Gamekeeper’s/Skier’s thumb: “Gamekeeper’s thumb” comes from Scottish gamekeepers who would kill rabbits by breaking their necks, causing chronic stress to this ligament over time. “Skier’s thumb” refers to the acute injury when falling while holding a ski pole, causing sudden forceful abduction of the thumb.
14. Jersey finger: The name comes from its common occurrence in American football when a player grabs another player’s jersey, and the finger gets caught and forcefully extended while actively flexing.
15. Mallet finger: (also known as baseball finger or drop finger) Common in sports when a ball strikes the fingertip. It can also occur from relatively minor trauma like tucking in bed sheets.

Read more about Hand Fracture on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a hand specialist today.