FINGER FRACTURE |
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General Information
DEFINITION--A complete or incomplete break in a finger bone.
BODY PARTS INVOLVED
Any of the bones of a finger, but usually the bone closest to the hand.
Any of the joints of the fingers, or the joints between the fingers and the hand.
Soft tissue surrounding the fracture site, including nerves, tendons, ligaments and blood vessels.
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SIGNS & SYMPTOMS
Severe pain at the fracture site.
Swelling of soft tissue surrounding the fracture.
Visible deformity if the fracture is complete and bone fragments separate enough to distort normal finger contours.
Tenderness to the touch.
Numb or cold finger or fingertip, if the blood supply is impaired.
CAUSESDirect blow or indirect stress on the finger bones.
RISK INCREASES WITH
Dislocation of a finger joint or of a joint between finger and hand.
Contact sports such as boxing or baseball.
History of bone or joint disease, especially osteoporosis.
Poor nutrition, especially calcium deficiency.
If surgery or anesthesia are needed, surgical risk increases with smoking and use of drugs, including mind-altering drugs, muscle relaxants, antihypertensives, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers or corticosteroids.
HOW TO PREVENTIf you have had a previous finger injury, use tape or padding to protect the finger when participating in contact sports.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's treatment to manipulate the broken bones.
Hospitalization (sometimes) for anesthesia and surgery to set the fracture.
Self-care during rehabilitation.
Whirlpool, ultrasound or massage (to displace excess fluid from the injured joint space).
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of injured areas, including joints above and below the primary injury site.
POSSIBLE COMPLICATIONS
Pressure on or injury to nearby nerves, ligaments, tendons, muscles, blood vessels or connective tissues.
Delayed union or non-union of the fracture.
Impaired blood supply to the fracture site.
Avascular necrosis (death of bone cells) due to interruption of the blood supply.
Arrest of normal bone growth in children.
Infection in open fractures (skin broken over fracture site), or at the incision if surgical setting was necessary.
Shortening of the injured bones.
Proneness to repeated finger injury.
Unstable or arthritic joint following repeated injury.
Prolonged healing time if activity is resumed too soon.
PROBABLE OUTCOMEIt is impossible to predict exactly how long it will take for any fracture to heal. Variable factors include age, sex, and previous state of health and conditioning. The average healing time for this fracture is 6 to 8 weeks. Healing is considered complete when there is no motion at the fracture site and when X-rays show complete bone union.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
Use a padded splint or sling to immobilize the hand and wrist before transporting the injured person to the doctor's office or emergency facility.
Use instructions for R.I.C.E., the first letters of REST,
ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
The doctor will realign and set the broken bones either with surgery or, if possible, without. Manipulation should be done as soon as possible after injury. Six or more hours after the fracture, bleeding and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and become difficult to return to a normal position.
CONTINUING CARE
Immobilization will be necessary. A splint is placed on the injured finger, extending beyond the finger-hand joint.
After 48 hours, localized heat promotes healing by increasing blood circulation in the injured area. Use a heating pad or heat lamp.
After the splint is removed, use ice soaks 3 or 4 times a day. Fill a bucket with ice water, and soak the injured area for 20 minutes at a time.
Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
MEDICATIONYour doctor may prescribe:
General anesthesia, local anesthesia, or muscle relaxants to make bone manipulation possible.
Narcotic or synthetic narcotic pain relievers for severe pain.
Acetaminophen (available without prescription) for mild pain after initial treatment.
ACTIVITY
Actively exercise all muscle groups not immobilized. These muscle contractions in the hand and arm promote fracture alignment and hasten healing.
Resume normal activities gradually after treatment.
Begin reconditioning the injured area after clearance from your doctor.
DIET
Drink only water before manipulation or surgery to treat the fracture. Solid food in your stomach makes vomiting while under anesthesia more hazardous.
During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs.
REHABILITATIONBegin daily rehabilitation exercises when movement is comfortable. Use ice soaks for 10 minutes prior to exercise. See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have signs or symptoms of a finger fracture.
Any of the following occur after surgery or other treatment:
Increased pain, swelling or drainage in the surgical area.
Signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).
Nausea or vomiting.
Swelling or irritation above or below the splint.
Blue or gray skin color beyond the splint, particularly in the fingertip or under the fingernails.
Numbness or complete loss of feeling in the injured finger.
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