Broken finger
Broken finger | |
---|---|
Other names | Finger fracture |
traumatic injury | |
Frequency | 0.012% of people per year in the United States.[1] |
A broken finger or finger fracture is a common type of bone fracture, affecting a finger.[1] Symptoms may include pain, swelling, tenderness, bruising, deformity and reduced ability to move the finger.[2] Although most finger fractures are easy to treat, failing to deal with a fracture appropriately may result in long-term pain and disability.[3]
The cause is usually
Anatomy
Location
Finger fractures are identified by the bone on which they occur. Fingers are numbered 1 to 5, with 1 being the thumb. The distal (tip) finger bones are divided into tuft (the very tip of the bone, at the end of each finger), shaft (the thinner middle section), and base. The rest of the finger bones (the middle finger bones, and the
The AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification generates language-neutral numeric codes for describing broken fingers. They run 78[meaning a fracture of the phalanges of the hand].[number-code of the finger, with thumb=1 and the little finger=5].[number-code of phalanx, counting 1 to 3 outwards from the hand].[number-code of location on the bone, with 1 being the inner end, 3 the outer, and 2 in-between]. So, for instance, 78.1.1.1 means a fracture to the thumb's innermost bone, at the inner end (the base of the thumb). A letter can be added to describe the fracture pattern.[4]
Fracture patterns
If the blow that breaks the bone bends it sideways, it will usually cause a
Fractures in the joints are often caused by jammed finger injuries, the hand equivalent of a stubbed toe. If a tendon pulls away the bit of bone to which it is attached (an avulsion fracture, shown in the image at the top of the page), that will also lead to a fracture in a joint.[1]
Causes
Putting out a hand to break a fall and landing badly can fracture a finger.
Occasionally, an infection or tumour can cause a broken finger;
Signs, symptoms and diagnosis
Symptoms include pain, swelling, deformity, decreased range of motion, and instability. There may be pain when the injury is probed.[1]
Sensation is checked to look for
Complications
-
On the index finger, a fracture of the shaft that does not affect the joint. On the right, a fracture affecting the ring finger's proximalinterphalangeal joint, or PIP joint
-
A Busch fracture, showing the characteristic mallet finger
-
Busch fracture mechanism: because the bit of bone attached to the tendon has broken off, the tendon can't extend the finger tip
Some finger fractures are severe enough to need surgery. In these severe cases, complications often occur, but most eventually heal functionally. Rarely, there are long-term complications, including decreased range of motion and deformity.[1]
A break that affects the joint surface may be displaced so that there is a step in the joint surface, which should be smooth. This will hinder motion and risks
A Busch fracture is a specific type of finger fracture where the base of a distal phalanx is affected.[5] Without adequate treatment, it can become a mallet finger.
Treatment
Broken fingers are treated in
Extraction
If a broken finger is trapped in an object, it must be freed[7] in a way that avoids further injury. Relaxation, elevation, icing, and lubrication (e.g. soapy water or oil) may suffice. If not, removal by other methods[clarification needed] can be done by a doctor; if the object is not portable, it is often done by paramedics or the fire department.[8]
As with other hand injures, any rings or bracelets are removed immediately, before the injury starts to swell.[7] Pulling rings off forcefully may worsen the swelling. Relaxation, elevation, icing, lubrication, and rotating the ring as if unscrewing it may help. If these methods don't work, it may be possible to remove the ring by temporarily wrapping the finger with a slick string (something like dental floss), passing the inner end of the thread under the ring, and then unwrapping it, pushing the ring ahead of the unwrapping string. Failing that, a doctor may remove it by other methods.[9]
Splinting
A broken finger may or may not require surgery. In simple cases, the bone may be
If the wrap that splints the finger is too tight, there is a risk of compartment syndrome. If the finger is numb, tingling, more painful, more swollen, or if the skin below the wrap is cool to the touch, the wrap may need loosening.[7]
The splint needs to be kept dry and may interfere with daily tasks, which will need to be done by someone else.[10]
Re-alignment
Many finger fractures are not displaced. Simple displaced fractures may be re-aligned (reduced) with a local anesthetic.[6]
Surgery may be needed for an unstable fracture (one that won't stay in the right place once reduced),[3] a finger broken in multiple places,[6] a fracture that extends into the joint between the broken bone and another bone, and a fracture with damaged tendon function[3] or damaged nerves.[6]
Pain reduction
Prognosis
Broken fingers and thumbs usually heal in 2–8 weeks, with 3–4 months for full strength.[6] Fingers mostly heal well in 3–4 weeks. Eating healthily and not smoking can speed healing. Pain should steadily decrease, with improvements starting within a few days of the injury.[10]
If it does not steadily improve, or if tingling, weakness, numbness, or signs of infection appear, it needs further treatment; see complications, above.[10]
Epidemiology
Broken fingers affect 0.012% of people per year in the United States. Finger fractures are common in children and old adults, but less common in the 45 to 85 age range. More male children break their fingers; in adults, only slightly more males. Wealthier people are less likely to break their fingers.[1]
The proximal (wristwards) finger bones are those most likely to be broken, and the smaller fingers are more likely to be broken than the index finger and thumb.[1]
Prevention
Prevention includes using protective equipment, avoiding unsafe use of tools and machinery, safety closers to avoid children's fingers being caught in slammed doors, and fall prevention. In sports, prevention includes gloves and avoiding high-hand-risk situations.[1]
See also
- Hand fractures
- Broken toe
- Finger bones
- Jammed finger
References
- ^ PMID 32491557– via PubMed.
- ^ a b c d e "Finger Fractures - OrthoInfo - AAOS". www.orthoinfo.org.
- ^ PMID 19468880.
- S2CID 39138324., page 87 of PDF fulltext
- ISBN 978-1-4471-0691-3.
- ^ a b c d e f g h i j "Broken finger or thumb". nhs.uk. October 17, 2017.
- ^ a b c "Finger, Hand, and Wrist Injuries". HealthLink BC. Britich Columbia Ministry of Health. Retrieved November 13, 2021.
- ^ "Trapped Finger, Toe, or Limb". HealthLink BC. Retrieved 13 November 2021.
- ^ "Removing a Ring From a Finger or Toe". HealthLink BC. Archived from the original on November 13, 2021. Retrieved November 13, 2021.
- ^ a b c d e f g h "Finger Fracture: Care Instructions". myhealth.alberta.ca. Retrieved 14 November 2021.