Fractures

What are hand and wrist fractures?

Fractures refer to bone breaks. There are 27 bones in the hand and wrist including:

  • 8 wrist bones (carpals)
  • 5 bones in the hand itself (metacarpals)
  • 14 finger bones (phalanges) – 2 in each thumb and 3 in each of the other fingers

The most commonly fractured bones in the hand and wrist are the finger tips and the ones at the base of the little finger and the thumb.

Hand and wrist fractures are typically caused by falling and landing on the hand or a direct blow to the hand. These are often the result of work injuries, crush injuries, falls and sports injuries.

As your hands are so important for everyday living, it’s important that any hand injury is treated promptly.

What are the symptoms of hand and wrist fractures?

Symptoms of hand and wrist fractures are:

  • pain
  • swelling and bruising
  • misalignment of fingers
  • weakness or inability to move fingers

Symptoms typically occur very soon after injury.

What does your doctor look for?

Your doctor will start with asking you about your how the injury occurred and about your pain. Your doctor will also do a physical examination looking for pain, swelling and misalignment, as well as for evidence of blood vessel, nerve or tendon damage.

What investigations are needed?

The most common investigation is an X-ray of the thumb, which shows typical features of osteoarthritis, including loss of joint space, osteophytes or bony swelling around the joint

How is base of thumb arthritis treated?

There is no cure for arthritis but there are several very effective treatments. All have the same goals – to control pain and improve the function of the elbow so that you can move better and get on with everyday living.

Treatments include:

  • non-drug therapy (eg rest, seeing a hand therapist for joint protection, thumb splints and exercises)
  • medications (egoral anti-inflammatories or joint injections)
  • surgery

Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.

Surgery for base of thumb arthritis

Surgery is usually reserved for when non-surgical options fail to relieve symptoms.

Surgery is usually performed under a general anaesthetic as a day procedure. It usually takes 30–40 minutes to complete. A tourniquet is placed above the elbow to ensure a bloodless field then an incision is made over the base of the thumb (palm side). The trapezium bone is removed, creating extra space in the joint. A small portion of one of the wrist tendons is then harvested and used to fill the affected space and stabilise the base of the thumb. The skin is sutured closed and a cast is then applied.

What investigations are needed?

Most hand injuries need to be X-rayed.

Your doctor may also do what’s called a nerve conduction study. This is where the speed of conduction through the nerve is measured at the level of the elbow and at the wrist. The test takes about 20 minutes to complete and is slightly uncomfortable to perform.

How are hand and wrist fractures treated?

Straight after an injury you should:

  • control any bleeding by placing a clean cloth to the area and applying pressure
  • remove any jewellery (as it may become impossible to take off once the area swells)
  • applying ice to the injury to reduce pain and swelling
  • place your hand on a pillow or cushion and carry it with you to your doctor

Hand and wrist injuries are generally treated by a hand specialist. Treatment will usually involve:

  • medications for the pain and swelling
  • re-alignment of any displaced bones
  • immobilisation of the fracture (eg splint, cast, external fixation or internal fixation)

Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.