Fingers are easily injured during daily activities and a finger fracture is among the most common injuries registered in the emergency room.
The finger is formed from three bones, the so-called phalanges, only the thumb has only two.
When a bone breaks, it is called a bone fracture (fracture), regardless of whether the bone is only broken or broken into several pieces.
This chapter is about acute or fresh fractures, as the treatment of an already healing bone is different.
The most common finger fractures from the finger foot to the fingertip are:
- tear-off fracture of the base of the finger (proximal phalanx);
- fracture at the foot of the base of the finger;
- fracture of the middle finger joint (proximal interphalangeal joint) with dislocation;
- oblique fracture of the middle of the finger;
- Fracture of the finger joint (distal interphalangeal joint).
The list could go on, there are countless possibilities of bone fractures affecting the fingers.
Contents
Causes
As a rule, the cause of a finger fracture is a direct force on the hand. This can happen when the finger is trapped in a door or when resting your hands on the floor to catch a fall.
Most often, the thumb, index and middle fingers break; Fractures of the ring finger are the least common.
Even in football, basketball or volleyball, the finger can break if the ball causes a sprain.
The risk of a finger fracture exists for children as well as for adults, even inattentive work with saw, drill and other equipment can be a cause.
Symptoms
Finger fractureTypical symptoms of a broken finger are pain that occurs immediately after the accident and sometimes a malposition of the bone or joint (dislocation). Even if there is no deformation, the fracture site causes great pain.
As a rule, a fracture is extremely painful, but often the finger can still be bent. Depending on stability, some fractures can cause more pain than others.
Normally, within about 5 – 10 minutes after the accident, swelling and bruising on the finger become noticeable, the finger becomes stiff and the movement becomes increasingly problematic.
The swelling is not limited to the injured area like the pain, it can also spread to the adjacent fingers.
In the case of a severe bone fracture, the bruise caused by the fracture is immediately visible.
In addition, with severe swelling, numbness in the finger may occur because the nerves are compressed.
Diagnosis
It is not always easy to determine whether a finger is broken, sprained or just pulled, as the symptoms are very similar: swelling, pain and stiffness.
First, the finger should be examined for malpositions. If a part of the finger is shifted in the wrong direction, there is probably a bone fracture or dislocation (i.e. the bone has left its natural seat, the malposition is often observed at the level of the knuckle).
A broken or dislocated finger looks like bruised (where the capillary blood vessels were injured), with a fracture the touch is felt as very painful.
A finger strain, on the other hand, means excessive stretching of the ligaments (the ligaments are strips of tissue that connect the bones together).
The finger should actually have no bruise or malposition, pain and swelling gradually subside over time. If you suspect a finger strain, you should spare your finger for a while to see if pain and swelling decrease within the next two days.
Diagnostic imaging
The diagnosis of a finger fracture is made by an X-ray examination.
The temporary use of a splint, ice and anti-inflammatory drugs from the group of nonsteroidal anti-inflammatory drugs are effective measures for first aid.
Treatment depends on the type of fracture. Each fracture has certain peculiarities that require individual care.
With a simple fracture, the doctor splinted the injured finger. The entire hand must be held still, so for practical reasons the whole hand is splinted.
For more complex injuries, the doctor can seek the opinion of an orthopedist (specialist in joints and bones).
Risks and complications
After surgery, infection or bleeding could occur. After the treatment, the finger may have suffered losses. Without rehabilitation, even everyday activities can cause difficulties.
The broken finger can increase in size or thickness due to excessive formation of bone callus, which is a completely normal reaction.
What to do? Treatment
Ice: The cold relieves swelling and pain; it can also prevent tissue damage.
Feel a bag of ice or cold water, wrap in a towel and place on your finger every hour for 15-20 minutes.
Elevation: The hand should be raised as often as possible (above the heart).
Two types of dressings are possible:
- compression bandage to relieve swelling,
- fixing bandage to block the finger joints; the broken finger can be tied to its neighbor.
In this way, swelling and pain can be alleviated.
The hand can be comfortably placed on pillows or blankets for elevated storage.
Physiotherapy can significantly reduce recovery times by applying magnetic therapy.
The treatment of finger fractures essentially depends on three factors:
- Depending on whether the fracture is “stable” or “unstable”, it can occur in connection with a sprain or dislocation;
- Is a finger joint affected by the fracture?
- Is there a malposition of the finger?
If a joint is affected by the bone fracture, it must be ensured that the joint surfaces are correctly aligned. The doctor examines the finger joints on the X-ray and checks whether the articular surfaces have any irregularities.
It is extremely important to know whether the fracture is “stable” or “unstable”. To find out, the doctor examines the shape of the bone fracture on the X-ray, where he can see if the fracture tends to slip or if it has a stable position.
Finally, the doctor examines the finger for malpositions, such as shortening or twisting. The fingers of the injured hand should actually be aligned in the same way as the fingers of the uninjured hand. This means that both hands must be the same length with outstretched fingers.
Furthermore, the fingers must not overlap when closing the fist, but must lie parallel to each other. However, if this is not the case, there could be a rotational deformity caused by the fracture.
The orthopedist will advise a cast or surgery based on this data.
Surgery
Surgical restoration may be necessary in the following cases to guarantee the full functionality of the finger after healing:
- in case of axial misalignment of the articular surfaces,
- in case of unstable or open bone fractures,
- in case of a malposition to be corrected.
Even if no treatment is necessary, a small splint can be attached to protect the finger; sometimes the neighboring finger can act as a splint.
If there is a malposition of the injured finger, it must be set up or “repositioned”.
This is often done with local anesthesia, which is injected into the small nerves at the foot of the finger. The injection numbs the finger so that the doctor can correct the fracture and correct the deformity.
Kirschner wires, plates and screws can be used to fix the bone fragments in the exact position.
Controls (follow-up)
After a finger fracture, a splint or bandage is very likely to be applied. This splint must not be removed prematurely, because it keeps the finger in the correct position during healing. It is also important to keep the bandage clean, dry and elevated until the swelling subsides.
Activities can aggravate the injury and increase pain, so the broken hand should not be used until the visit to the orthopedist.
A specialist may want to see the patient for another X-ray a week after the accident so they can assess the position of the bones.
If the finger is not exactly aligned, it may not be possible to heal one hundred percent and the usability of the hand can be permanently impaired.
Rehabilitation
As soon as the finger is allowed to be moved with the permission of the doctor, the hand must be used. Rehabilitation with daily simple exercises helps to reduce swelling and stiffness in the finger.
In the first phase of rehabilitation, passive mobilization by the physiotherapist takes place, which is intended to increase the range of motion.
As soon as the patient is able to actively work with the finger, active movement exercises (physiokinesiotherapy) are on the program to regain the full functionality of the hand.
How long does it take to heal? Prognosis
After setting up the fracture, immobilization prescribed by the orthopedist and 3 to 4 weeks of rehabilitation, the fracture should be completely healed.
The most common problem after treating a finger fracture is joint stiffness.
When the fingers are immobilized, the joint capsule and the soft tissue structures surrounding the joint retract, restricting joint movement.
It is important that the bone heals before the joint becomes too stiff and a reduction in movement occurs.
For many patients, physiotherapy can help them regain their full ability to move.
Stiffness and swelling can be a cause for great concern and develop into a serious problem if left untreated.
Physiotherapy is important to restore full mobility.
The physiotherapy exercises are intended to bring back mobility and strength; they are initially passive in nature, but as soon as the pain allows, the fingers must be moved actively and against resistance.
The healing times depend on the severity of the bone fracture, if the bone is only broken, a full recovery takes place in 3 to 4 weeks, a postponed fracture can also take up to 3 months.
