Metacarpal Fracture: A Broken Hand

If you have a "broken hand," you have a metacarpal fracture -- an injury to the bone at the level of the palm of your hand. You have five metacarpal bones, one for each of your fingers. The metacarpal bones support the hand, and the end of the metacarpal bone forms the knuckle on the back of your hand.

How Does a Metacarpal Fracture Occur?

Metacarpal fractures can occur with a variety of injuries, including:

• falls
• sports injuries
• fist fights or punches
• car accidents

What Are the Signs of a Metacarpal Fracture?

Typical symptoms of a metacarpal fracture include pain and swelling of the hand. While bruising may not be seen immediately, there is usually bruising that develops within a few days of the injury.

What Is the Treatment of a Metacarpal Fracture?

Treatment of a metacarpal fracture can usually be accomplished with the use of a cast. A cast is usually worn for about 6 weeks, followed by gentle motion exercises. Occasionally, if stiffness becomes a problem after cast treatment, a hand therapist will be recommended to work with you.

There are a few situations where surgery may be recommended. If there are multiple fractures, or open fractures of the hand, surgery may be recommended. In the setting of an isolated metacarpal fracture, your doctor will assess two factors to determine if surgery is necessary:

• Length
  Your doctor will determine if the finger is shortened because of the fracture. If it is, your doctor may recommend surgery to restore normal length of the finger.

• Rotation
  If the finger is rotated, your doctor may recommend that this deformity gets corrected. Rotation can be assessed by making a fist. If the fingers cross over each other, there is likely a rotational deformity.

If surgery is needed, your doctor may fix the broken bone with wires, plates or screws. The type of fixation depends on the specific type of fracture.

_Sources:

Henry MH "Fractures of the Proximal Phalanx and Metacarpals in the Hand: Preferred Methods of Stabilization" J. Am. Acad. Ortho. Surg., October 2008; 16: 586 - 595.