Surgical and Nonsurgical Options for Treating Hand Fractures

Dr. Gregg Vagner offers both surgical and nonsurgical options for treating hand fractures at his Austin, TX,  practice. Your hand is made up of over 20 different bones, including short carpals, phalanges, and metacarpals. These bones serve as a support system for the muscles within your wrist and fingers. If a bone is fractured or broken, it can inhibit proper movement and cause severe nerve and tissue damage when the fracture is not addressed immediately. Fortunately, Dr. Vagner has many years of experience and can use either conservative nonsurgical treatment or perform surgery to ensure proper healing.

Which Bones Are Contained within the Hand?

A diagram of the bones that comprise the hand
Hand fractures can occur from a variety of factors, such as a bad fall, severe twist, contact sports injury, or car accident.

Hand Anatomy: Incredibly Engineered

Orthopaedic hand surgeon Dr. Gregg Vagner explains the incredibly complex anatomy of the hand.

Each hand consists of 27 unique bones that serve as a framework for your muscles, tissues, nerves, and skin. These bones work together to promote proper hand function. The bones in your hand are broken down into three different groups: 

  • Carpals: Bones within the base of your hand that connect your hand to your forearm. Also referred to as your wrist bones.
  • Metacarpals: Long bones within the middle of the hand that connect your carpals and phalanges and are responsible for the movement of your knuckles. Ten percent of all hand fractures occur in the metacarpals.
  • Proximal, intermediate, and distal phalanges: These 14 long bones all connect to each other and make up your thumb and fingers. The majority of hand fractures occur to the phalanges.

Symptoms of a Hand Fracture

The side effects of hand fractures vary depending on the type and severity of the break, but you should seek medical attention as soon as possible if you are experiencing symptoms such as:

  • Swelling, pain, stiffness, or tenderness 

  • Hand deformity or shortened finger
  • Inability to move hand, wrist, or fingers 

  • Depressed knuckle
  • Tingling and loss of feeling within your fingers

If you are concerned you have a fractured bone within your hand, it is imperative that you schedule an appointment with Dr. Vagner as soon as possible in order to prevent further damage from occurring.

Diagnosing Your Injury

To confirm a hand fracture, Dr. Vagner will perform a comprehensive assessment at our office. During this visit, he will ask you about your symptoms and visually evaluate the area of concern by checking for:

  • Swelling and inflammation
  • Bruising
  • Deformity
  • Cuts or lacerations
  • Overlapping of the fingers
  • Joint stability
  • Limited range of motion
  • Numbness or tingling in the fingers

In addition, we will use diagnostic imaging to determine the exact location of the break. An x-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan can also help him detect if any adjacent nerves, tendons, and ligaments have been damaged. Once Dr. Vagner has adequately reviewed the images, he can create a treatment plan to help restore your hand back to full function.

Types of Fractures

Illustrations showing types of fractures
Identifying the type of fracture will allow Dr. Vagner to provide the most effective treatment option.

There are several types of hand fractures that can occur, and they are categorized according to the extent of damage sustained. These include:

  • Stable fractures: When the bone fragments are in alignment, it is referred to as a stable fracture. This injury is considered minor compared to the other types of fractures.
  • Unstable fractures: In this scenario, the bone fragments have shifted out of place. When this occurs, the pieces will need to be realigned before treatment.
  • Comminuted fractures: One of the most severe types of breaks, a comminuted fracture occurs when the bone has been shattered into several pieces. This requires significant repair.
  • Compound fractures: If the bones have been shattered and they pierce through the skin, it is referred to as a compound fracture. This type of break significantly increases the risk for infection. 

Available Treatment Options for Hand Fractures

The type of treatment recommended for you will depend on the type and severity of the fracture. For a simple break, Dr. Vagner can generally perform conservative treatment by immobilizing the joints with a cast or splint. For more complex cases, such as an unstable, comminuted, or compound fracture, surgery is generally required to realign the bone fragments. This can be achieved with internal or external fixators.

Internal Fixators

Once the bone fragments are realigned, surgical plates, pins, screws, or wires can be used to stabilize the hand. These components are crafted from surgical-grade steel, titanium, cobalt, or chrome, all of which are biocompatible materials.

  • Plates: These devices are attached to the bone with screws and serve as internal splints.
  • Screws: Versatile in their use, surgical screws may be used alone to stabilize a break, or they may be used in conjunction with rods, plates, or nails. 
  • Pins: Surgical pins may be used to stabilize the bones while they heal. Most of the time, pins extend through the skin and will be visible during the healing process.
  • Wires: Used alone or in conjunction with other forms of internal fixation, wires are frequently used to treat fractures of the hand. They may be left permanently or removed, depending on your specific situation. 

External Fixators

In contrast to an internal fixator, which is contained beneath the skin, an external fixator serves as a stabilizing frame outside of the body. When using an external fixator, small incisions are created in the skin and muscle near the fracture. Screws and pins are inserted into the bone, then attached to the external device for support. This type of treatment is often indicated when a patient has sustained multiple injuries and is not yet ready to undergo more extensive surgery.

Recovery following Hand Surgery

If you require surgical intervention to address your hand fracture, you can expect to wear a splint or cast for several weeks after the procedure. Dr. Vagner will supply you with a brace to help keep the hand elevated and will send you home with at-home care instructions to assist you with your recovery. He will carefully monitor the break through a series of follow-up appointments that will include x-ray imaging to ensure you are properly healing. 

Small breaks, such as hairline fractures, generally do not require physical therapy. However, if joint stiffness is present following the initial healing, then Dr. Vagner will refer you to an experienced hand therapist who can recommend a series of stretches and exercises to aid in your recovery.

The recovery timeline after a hand fracture can vary depending on your age and the complexity of your case. While children may heal as quickly as one month, adults typically require several weeks to several months. Dr. Vagner can let you know approximately how long it will take for your fracture to heal during a consultation.

Contact Us Today

If you are concerned you have a fractured bone within your hand, it is imperative that you schedule an appointment with Dr. Vagner as soon as possible in order to prevent further damage from occurring. You can schedule an appointment online or call (512) 476-2830 to speak to a member of our team. 

Contact Us

"I am committed to using experience, along with the latest techniques and technologies, to help my patients achieve the full function, mobility, and comfort in their hand, wrist, and arm that they experienced prior to their injury." Dr. Gregg Vagner

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