Hand Fracture

About Hand Fracture

Hand fractures involve the small bones of the fingers and thumb, called the phalanges, and the metacarpals of the palm. Even apparently minor cracks can affect everyday activities, from writing and typing to gripping a steering wheel. Accurate diagnosis and the right balance between rest and movement are essential for a strong functional recovery.

Many hand fractures heal well without surgery if alignment is acceptable and the joint surfaces are not displaced. Conservative care relies on splinting, controlled mobilisation and regular review with X-rays. However, malrotation, joint involvement or significant displacement usually require surgery. Our team in Lucknow examines every patient carefully so neither over-treatment nor under-treatment occurs.

Treatment goals are clear: reduce and stabilise the fracture, maintain that reduction throughout healing and start early rehabilitation to prevent stiffness. Each finger has three joints, the distal interphalangeal, proximal interphalangeal and metacarpophalangeal joints, that are commonly involved in fractures. Stiffness in these joints can be very disabling, which is why structured therapy is started early.

Surgical options include closed reduction with K-wires, miniplate and screw fixation, and external fixation for severely comminuted fractures. The choice depends on fracture pattern, bone quality and soft tissue condition. Where the fracture extends into a joint, careful articular reduction is essential to reduce the risk of long-term arthritis and persistent pain.

In children, the Salter-Harris classification helps describe how a fracture relates to the growth plate, ranging from Type 1, confined to the physis, to more complex Type 4 fractures crossing the growth plate, shaft and joint. Dr. Agarwal, FRCS Edinburgh, plans paediatric care carefully so growth and joint surfaces are protected as the bone heals.

What to expect

• Detailed clinical examination and X-rays
• Discussion of conservative versus surgical care
• Splinting or K-wire fixation when appropriate
• Miniplate and screw fixation for complex patterns
• Articular surface reduction when a joint is involved
• Early controlled motion to prevent stiffness
• Coordinated paediatric care for growth plate injuries

Recovery

• Splint or cast for two to four weeks as needed
• Hand therapy started as soon as it is safe
• Antibiotics and analgesics for surgical cases
• K-wire removal usually around three to four weeks
• Gradual return to gripping tasks over six weeks
• Imaging review to confirm bone healing