Although the bones in the fingers are small, a finger fracture is not a minor injury. Fingers are capable of very fine, coordinated motions and disruption of this motion can make it difficult to do simple tasks and activities. Think about it; fingers let us touch, grasp, and interact with our environment. They allow us to perform specialized functions such as simple as eating, grasping a pen, playing an instrument, or typing on a computer. A finger fracture can cause dysfunction in the entire hand. if not treated properly, finger fractures and dislocations can have significant consequences, including poor function, chronic pain, stiffness, and deformity. Without appropriate treatment, your broken finger may end up misaligned, stiff, or painful. Even if you can tolerate the pain, you should still see an orthopedic specialist at OCC – Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado to avoid significant consequences. The chances of successful treatment increase the sooner your treatment starts.

OVERVIEW

A finger fracture or broken finger is a common bone break. It is the most frequently injured part of the hand. Finger fractures are the most common sports-related fractures in adults and teenagers in the United States. They are common in children and older adults, but less common in the 45 to 85 age range. More male children break their fingers; in adults, only slightly more males. Fractures of the pinky finger’s bones occur at the staggering rate of over 33% of all hand fractures among adults. A fracture can occur in any of the bones in the fingers.  Fractures can also occur in the knuckles, which are the joints where the finger bones meet. A finger fracture might be a ‘hairline’ fracture (a small crack), a partial fracture, which is common in children, or a complete break, where the bone can be broken into two or more pieces.

ABOUT THE FINGERS

Small bones make up the finger structure. The bones in a normal finger line up precisely. Each finger contains three phalanges, while the thumb contains two. These bones are called “phalanges”, and an individual bone is called a “phalanx”. There are 14 bones in total in the fingers (phalanges) of each hand, each of which is susceptible to fracture. Joints are cartilage surfaces that connect bones to each other. This cartilage allows the bones to glide smoothly against one another, allowing for painless movement. There are four joints in each finger, totaling 20 joints in each hand. The metacarpal bones are the 5 bones that compose the middle part of the hand. The index and middle finger metacarpals have very little motion, while the metacarpals of the ring and little finger move much more. There are no muscles in the fingers, they move by the pull of the forearm muscles on the tendons which attach tissue from muscle to bone.

WHAT IS FINGER FRACTURE?

There are many different types of finger fractures:

• Closed: the most common type
• Open: when the bone breaks through the skin or the skin tears over the location of the fracture
• Oblique: occurs with diagonal loading (falling and hitting hand)
• Spiral: due to rotational force (finger caught in drill)
• Transverse: usually from crush injury ( dumbell falls on finger)
• Comminuted: multiple fragments
• Avulsion: a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of a bone
• Tuft: most common type of distal phalanx fracture—a break in the tip (tuft) of the finger
• Seymour: a break in the bone at the end of the finger at first joint
• Boxer’s: fracture of metacarpal bone that attaches to a little finger, typically caused by a punching force

Some lesser-known fractures are:

• Bennet’s Fracture: a fracture that occurs at the base of the thumb, specifically at the metacarpal bone. It’s rare compared to other finger fractures and often happens during activities that involve a strong gripping motion, like punching
• Rolando Fracture: a more complex version of Bennet’s fracture where the bone breaks into multiple pieces at the base of the thumb
• Stress fractures in fingers: although rare, they can occur in the fingers, especially in athletes who engage in repetitive finger movements, such as rock climbers or gymnasts.
• Mallet Finger: often used interchangeably with the term “ baseball finger” which is a specific type of finger fracture that occurs when a ball strikes the tip of an outstretched finger causing the tendon to rupture and the bone to fracture. Despite the name, it’s common in many sports, not just baseball

CAUSES

Some common causes include:

• Injury or weakened bones
• Putting out a hand to break a fall
• Slamming finger in drawer or door
• Car Accident
• Using tools such as drills, power saws, or hammers
• Sports that increase the risk for finger fracture are:
• Basketball
• Baseball
• Volleyball
• Hockey
• Rugby
• Boxing
• Skiing
• Wrestling
• Snowboarding

SYMPTOMS

Some common symptoms include:

• Pain
• Bruising
• Numbness
• Problems bending the finger
• Redness
• Stiffness
• Swelling
• Tenderness
• Limited range of motion
• The finger bent out of its normal position

NON-SURGICAL TREATMENTS

Most finger fractures can be treated with non-surgical methods when the fracture is stable, meaning the bone fragments are well-aligned and there is no significant displacement. Common conservative treatments:

• RICE therapy — rest, ice, compression, elevation
• Immobilization — splinting or casting. Sometimes, with more minor injuries, it is possible to use an adjacent finger as a splint, a process known as “buddy taping”
• Pain management — over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen. Prescription meds if pain is severe
• Physical Therapy

WHEN IS SURGERY INDICATED?

The majority of finger fractures can be treated without surgery. Surgery may be required with:

• Multiple fractures
• Loose bone fragments
• Damage to the ligaments or tendons
• Comminuted fracture: bone has broken into two or three pieces
• Unstable, displaced, or open fractures
• Compression fracture: where the bone is crushed as if it has been slammed into a door
• An impaction fracture: similar to compression fracture it is a closed fracture that occurs when pressure is applied to both ends of the bone, causing it to split into two fragments that jam into each other
• Segmental fracture: finger bone has been broken in two locations leaving a portion of the long bone “floating” between
• Joint Fracture: a serious disruption of one or both bony articular surfaces

Depending on the type and severity of the fracture there are several options to put the bones into alignment and keep them there while they heal. Small devices, such as pins, screws, plates, or wires may be used. Sometimes, these devices can stay in for life, and sometimes they need to be removed after the fracture heals.

GETTING THE RIGHT DIAGNOSIS.  GETTING THE RIGHT DOCTOR.

One of the things that makes seeing an orthopedic expert at OCC – Advanced Orthopedic & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado, is not just their extensive experience diagnosing and treating finger fractures, but also their dedicated thoroughness in dealing with the most complex conditions. In a detailed physical examination, your doctor may want to see how your fingers line up when you extend your hand or make a fist. Does any finger overlap its neighbor? Does the injured finger angle in the wrong direction? Does the injured finger look too short? X-rays are then necessary to determine not only whether there is a finger fracture, but the nature and severity of that fracture. The doctor must determine whether the fracture involves a joint, and, if so, whether the joint surfaces are in alignment. The X-ray will also allow the doctor to determine whether the fracture is unstable, that is, likely to slip out of its correct position. Finally, the doctor has to assess any possible deformities of the finger, such as inappropriate rotation or shortening.

All of this information is important in determining how the fracture is to be treated. But it doesn’t stop there. Your doctor will also look for injuries to other nearby structures. It is not uncommon for a finger that is fractured to also have injuries to tendons, nerves, and/or ligaments. These injuries may need to be treated along with the broken bone(s). They need to know if your finger is only sprained or jammed, which aren’t considered fractures. All of the symptoms of a finger fracture may be the result of other problems such as infection. It is essential to consult a surgeon with the advanced knowledge, expertise, and experience as those at Advanced Orthopedics for a definitive diagnosis, as the treatments for every condition vary, and improper treatment may lead to permanent disability.