Broken finger (fractured finger) Matimati tāwhatiwhati

A broken finger usually happens as a result of an injury, such as when you:

• slam your fingers in a door
• put your hand out to break a fall
• jam your finger when you try to catch a ball
• have an accident while working with tools.

Each finger has 3 bones:

• the proximal phalanx (closest to the palm of your hand)
• the middle phalanx
• the distal phalanx (the fingertip end).

Your thumb only has 2 bones, the proximal and distal phalanges.

Finger bones can break in several ways, including:

• straight across
• in a spiral
• a small chip (avulsion)
• into several pieces.

Sometimes you can break and dislocate one of your finger joints at the same time. This can be a more serious injury to treat.

Dislocated joints

If you have an injury and one or more of the following symptoms, you may have broken a finger:

• your finger is swollen, bruised and tender
• you cannot move the injured finger properly
• your injured finger is out of shape (deformed).

If you think you have broken a finger, it is important see a healthcare provider, hand therapist or physiotherapist. They will ask questions about how you injured your finger and examine your hand. They may also send you for an x-ray to find out which bone is broken and how it is broken.

X-rays

How your finger is treated will depend on what the break looks like. Most are simple breaks, with the ends of the 2 pieces of bone still together. These are usually treated without surgery.

Your finger is likely to be splinted or strapped to another finger to provide extra support (buddy strapping) until your bone is healing and your finger feels more comfortable.

You may need surgery if:

• your break is unstable
• the broken ends are not together (they are displaced)
• the break involves the joint surface
• has pulled off an important ligament.

There are some things you can do to help your recovery, whether or not you are having surgery.

• If you are a smoker, stop smoking. Smoking slows the healing process.
• Take regular pain relief as recommended by your healthcare provider. Seek advice from your healthcare provider if you still have pain while taking the recommended pain relief. Do not take extra pain relief that has not been prescribed for you.
• For the first 2 days, keep your hand raised (elevated) to reduce swelling. For the first 1 to 2 days, apply ice for 15 minutes every 4 to 5 hours to reduce pain and swelling. Wrap ice (or a bag of frozen peas) in a cloth — do not put it directly onto your skin.
• Keep your other fingers, hand, wrist and elbow moving to stop them from becoming stiff. If your finger is buddy strapped (to the next finger), keep it moving as well.
• Avoid lifting or carrying anything with your injured hand.
• Avoid sport or any other activity that could make your injury worse.
• As the pain gets better, start doing gentle hand exercises, especially for the fingers and thumb.

Pain relief medicines for adults

If you need surgery, it will be done by a specialist hand surgeon — an orthopaedic (bone) surgeon or a plastic surgeon. The surgery you have will depend on what type of break you have. Your surgeon will discuss this with you, including the risks and benefits of surgery and how you are likely to recover.

Whatever surgery you have, it will involve some metal (a plate, screws or possibly wires) to align your bone properly and support it while it heals.

Surgery usually involves spending a night in hospital, and your finger will be in a splint for up to 6 weeks.

Recovering after surgery

You will need at least a week off work after surgery. You may need longer if:

• the break is in the hand you use most (dominant hand)
• your job involves manual or heavy physical work (there may be light duties you can do).

You will not be able to carry or lift anything for about 2 months.

As you recover, you will have regular appointments with your surgeon and some x-rays to make sure your finger is healing well.

If wires have been placed in your broken finger, they may be buried under your skin or they may be poking out from the end of your finger. They will probably need to be removed.

Most often they are poking out and will be removed at a later clinic appointment. This is not usually painful but it is a good idea to take some pain relief before you come to this appointment. If the wires are under your skin, you may need another operation to remove them.

You will need to see a hand therapist for advice and exercises to strengthen your hand and get it moving again.

Find a therapist — Hand Therapy New Zealandexternal link

Self care after surgery

While you are recovering, you should avoid:

• lifting or carrying anything with your injured hand
• any sport or other activity that could make your injury worse.

Your surgeon will let you know when it is safe to do these things again.

If wires are poking out the end of your finger, it is important to protect them so they do not get caught on clothing or are accidentally pulled out. If this happens, it can be painful. You may also need more surgery to put them back in, which can affect how well you heal and how well your hand works in the future.