A hand, wrist, or thumb fracture can range in severity from a thin crack to a shattered or crushed bone. Because we depend so heavily on the intricate coordination of all the delicate bones that make up our fingers, hands, and wrists, an injury that might seem minor because of small bone size nevertheless needs to be taken seriously. Like an elaborate belt and pulley system, each bone, ligament, and tendon is depended upon to make the whole hand function optimally. Our Houston hand specialists can help you.
The most common ways of referring to different kinds of bone fractures:
- Closed: bone does not break through the skin
- Open (or compound): bone protrudes from the skin
- Hairline: a thin crack in the bone
- Single: breakage in one location only
- Segmental: breakage in two locations
- Comminuted: breakage into multiple pieces
- Displaced: breakage into uneven pieces, making realignment difficult
- Non-displaced: breakage into fairly even pieces, making realignment easier
- Greenstick: bone has broken on one side and is bent on the other
- Torus: bone has broken on one side, causing a bump on the other side
While there are always exceptions, if you have a broken bone, you are usually in pain, particularly upon moving adjoining areas. Symptoms of a break in the hand, wrist, or thumb include the following:
- Swelling, bruising, and if open, bleeding
- Intense pain
- Inability to move the affected area
- Numbness and tingling in the affected area (sometimes)
Time is of the essence in stabilizing the hand, wrist, or thumb to avoid further injury, more swelling, and internal or external bleeding. In the ER or primary care office, an X-ray may be ordered, or an MRI if soft tissue damage is suspected. Houston patients will be referred to an orthopedic specialist if a fracture is confirmed.
The most common kinds of breaks are caused by the following:
- Trauma: typically caused by bearing all the weight of a fall on the hand, wrist, or arm, a vehicular accident, or a sports injury.
- Osteoporosis: bones are weakened by this condition and more easily broken by minor stressors.
- Overuse: when muscles fatigue from overuse, the pressure on the bone may be strong enough to cause a fracture.
Common sites of fractures:
Scaphoid fracture: one of eight tiny wrist bones, the scaphoid is most commonly broken if the wrist is used to cushion a fall—often on slippery sidewalks, and in snowboarding, inline skating, hockey, or other sports.
Colles fracture: a break in the radius bone of your forearm (the one on the thumb side), usually about one inch from where it joins the wrist bones. It is also frequently caused when the wrist is used to cushion a fall.
Thumb and finger fractures: Bones are naturally rigid but can bend a little if an outside force is applied. But catching your thumb or finger in a way that creates a sideways or backward bend can result in a fracture. Sports, breaking a fall with the hand, and operating machinery are common culprits in this injury.
Other fractures we see of the hand, wrist, and thumb include joint dislocations and ulnar bone fractures near the wrist.
If you think you have broken a bone, the first step is to immobilize the affected area and get to a Houston doctor or ER for evaluation. While you are in transit, a makeshift splint like a rolled magazine may help keep a broken wrist supported. Keeping your arm raised and gently applying ice is helpful in reducing swelling, making treatment easier.
Treatment of fractured bones falls into these broad categories:
- Stabilize/immobilize for self-healing (hairline fractures and some simple fractures can be treated this way)
- Realign bones by manipulation: closed, non-displaced fractures with one and sometimes two fracture sites may be candidates
- Surgically realign bones: non-displaced fractures
- Surgically realign or repair bones (sometimes with the use of bone grafts) by using hardware such as pins, screws, plates, or wires, temporarily or permanently, to hold bone alignment in place
Casts, splinting, and other appliances and aids are used in various combinations to allow fractures and joint dislocations to heal. This usually takes 3-6 weeks, depending on the nature and location of the break, as well as the age and overall health of the patient.