Finger fractures are a common injury to the upper extremities these days. The hand is the primary tool of human labor in everyday life, and the loss of its functionality, even for some time, causes significant inconvenience. If a fracture is not taken seriously, it can end sadly.
What is a finger fracture?
Each finger is made up of several small tubular bones called phalanges. The thumb has two of them, and all the others have three: nail, middle and main.
In traumatology, a fracture of the fingers is considered a pathological condition in which the integrity of the phalanges is violated. In this case, the bones take an abnormal position, resulting in pain.
Each finger has a certain number of phalanges
There are many different classifications of finger fractures. In modern medical institutions, several are used at once to make an accurate diagnosis. This approach allows both to group and separate completely different fractures from each other.
Classification of injury
Fractures of the fingers are included in the general classification of traumatic injuries. Like all tubular bones, the phalanx has a special structure: two thickened ends, between which the body of the bone is located. This structure has a cavity called the medullary canal.
According to etiology (origin) there are:
- Traumatic fractures. They arise due to the impact of any active damaging factor on a healthy bone, leading to a violation of its integrity.
- Pathological, or atypical, fractures. The main reason for their appearance is pathophysiological processes in bone tissue: its demineralization, a decrease in the density of the basic substance and a decrease in elasticity.
Based on the depth of the fracture, there are:
- Brokenness. Less than half the diameter of the bone is damaged.
- Cracks. Characterized by deepening of the damage to more than half the diameter of the bone.
- Cracking. This is a pathological process in which the bone is covered with small cracks running in different directions.
Based on the degree of soft tissue damage, the following are identified:
- Open fracture. It is characterized by damage to muscles, subcutaneous tissue, skin, and sometimes injury to vascular trunks. In an open fracture, bone fragments are visible in the wound and can become a source of bacterial infection.
- Closed fracture. It implies maintaining the integrity of soft tissues if a bone defect is present. The main manifestation is pathological displacement of the finger.
Depending on the nature of the fracture line, injuries are distinguished:
- Oblique. The fracture is located at a certain angle to the surface of the damaged bone.
- Transverse. The fracture line is located relatively perpendicular to the surface of the bone.
- Longitudinal. The fracture line runs parallel to the axis of the bone.
- Screw or spiral. The fracture is uneven, “twisting” in nature with jagged edges.
- Fragmentation. As a result of this type of injury, more than two bone fragments are formed, each of which has its own fracture line.
Classification according to the presence of displacement:
- No offset. Bone fragments do not change their position relative to each other.
- With offset. The edges of the fragments are displaced relative to each other:
- displacement in width occurs due to the action of a traumatic mechanism;
- the displacement along the length is caused by the traction of the muscles of the upper limb;
- angular displacement is formed due to contraction of the flexor and extensor muscle groups in the wrong order;
- displacement along the axis occurs due to intense rotation of one part of the bone relative to another.
Specific types of phalangeal fractures
Unlike other tubular bones, the phalanx of the finger is a unique element. It is one of the smallest in the skeleton, intensively supplied with blood and has the strongest periosteum.
Classification according to the location of the fracture on the limb:
- Fracture of the thumb. It is one of the most common injuries of the upper limb, which is caused by the opposition of the thumb relative to the rest.
- Fracture index finger. Second most common. Most often it breaks along with the middle or ring finger.
- Middle finger fracture. Doesn't have any special features.
- Fracture of the ring finger. A specific feature of this injury is the difficulty of full rehabilitation, which is associated with a limited range of motion of the finger.
- Fracture of the little finger. This finger contains the smallest bones, which can cause difficulties in applying a plaster cast.
Classification according to the location of the fracture on the phalanx:
- Fracture of the nail (or distal) phalanx, otherwise known as a fingertip fracture. Occurs predominantly in males. This bone is very fragile, and even a minor injury can lead to dire consequences.
- Fracture of the median phalanx. Quite rare and occurs in 20% of all cases, because the main phalanx takes most of the mechanical impact.
- A fracture of the main phalanx, also called a fracture of the base of the finger. In most cases it occurs in combination with dislocation or subluxation of the thumb.
- Intra-articular fracture. Characterized by damage articular surfaces, which leads to disruption of the physiological function of the finger. Quite often combined with fractures of the nail phalanx.
Fracture of the nail phalanx is the most common
Main causes and development factors
Unfortunately, in most cases, risk factors and causes of fracture are very closely intertwined, which creates certain difficulties in preventing the disease.
Depending on a person’s ability to influence the situation, risk factors are divided into modifiable, which can be corrected, and non-modifiable.
In most cases, the impact of adverse factors can be minimized by carefully monitoring your lifestyle. Quitting bad habits sports training And proper nutrition can significantly reduce the risk of fracture.
Risk factors - table
| Risk factors that increase the likelihood of fractures | |
| Modifiable risk factors | Non-modifiable risk factors |
| Bad habits: nicotine and alcohol reduce the regenerative ability of bone tissue, which leads to the formation of various fractures. | Female gender: due to a sharp decrease in estrogen during menopause, bone formation is disrupted. |
| Deficiency of calcium and phosphorus in the body: during demineralization, atypical bone cells are formed that are prone to rapid death. | Old age: Senile degenerative changes in the cartilage and bone matrix contribute to the occurrence of fractures. |
| Lack of physical activity: regular loads strengthen the musculoskeletal system, which increases bone density. | Constitution: it is known that asthenics suffer from various fractures much more often than people of normosthenic and hypersthenic physique. |
| Long-term use of medications leads to hormonal imbalance in the body, resulting in fractures. | Hereditary diseases associated with mutations in genes encoding information about bone density. |
| Impaired absorption of nutrients contributes to the development of exhaustion and the formation of energy deficiency, which negatively affects the regeneration of bone tissue. | Race: scientists have found that people of the Caucasian and Mongoloid races are more susceptible to bone fractures than others. |
Causes of a broken finger - table
| Causes contributing to fracture | |
| Traumatic causes | Diseases that cause increased bone fragility |
| Strong blow to a limb | Malignant and benign bone tumors |
| Falls (especially if you happen to fall on the hand area) | Tumor metastases to the bone from other organs: kidney cancer, brain cancer, etc. |
| Incorrectly applied splint for a bruise | Echinococcosis |
| Excessive strain during exercise | Tuberculous bone disease |
| Violation of safety regulations during sporting events | Hematogenous osteomyelitis |
| Accident or accident at work | Secondary and tertiary syphilis |
| Compression or sprain of a limb | Osteomalacia (softening of bone tissue) and rickets |
| Pathological muscle tension | Osteosclerosis (pathological hardening of bone) |
| Violation of the integrity of the callus (repeated fracture) | |
Symptoms and first signs
Many people are concerned about how to recognize an injury in time. In some cases, intense pain appears after several hours or even days. A broken finger can easily be confused with a bruise or dislocation, which can delay a trip to a traumatologist. An incorrect diagnosis leads to unpleasant consequences that will take a long time to eliminate.
To understand at the first stages whether a finger is broken or not, it is enough to know a number of reliable signs of pathology.
Reliable symptoms of an open fracture:
- presence of a wound: damage to the skin with bone fragments;
- bleeding from cut vessels;
- severe pain;
- inability to bend or straighten a finger;
- displacement of fragments relative to each other;
- pronounced swelling and hyperemia of the hand.
An open fracture is characterized by the presence of a wound
Reliable symptoms of a closed fracture:
- crepitus (crunching of bone fragments);
- pathological mobility of the bone: it can bend and unbend in places where there is no joint;
- swelling and hyperemia that does not go away for a long time;
- intense pain when touched, which goes away only after using painkillers.
A distinctive feature of a closed fracture is the deformation of the finger and its swelling
It is quite difficult to distinguish a closed fracture from a severe bruise, guided only by clinical signs. To establish an accurate diagnosis, it is recommended to contact the trauma department.
Diagnostic measures
For the purpose of differential diagnosis between a bruise and a fracture, the doctor carefully collects anamnesis: the place and time of injury, the intensity and duration of the pain syndrome, the functioning of the affected finger. During the examination, the traumatologist pays attention to the color of the skin, the intensity of edema and the presence of crepitus.
Reliable laboratory techniques to separate a bruise from a fracture have not currently been developed. But instrumental diagnostics are widely used: radiography of the finger in frontal and lateral projections will allow an accurate diagnosis. The image will clearly show the defect in the structure of the bone tissue. Using this method, you can determine the depth and location of the fracture, the presence of small fragments and their displacement.
X-rays of a finger fracture - photo gallery
An x-ray in two projections is required when diagnosing a fracture 
It is not always possible to see a fracture on a lateral image. 
Most fractures are detected on direct x-rays
Treatment
For every injury it is necessary integrated approach. Properly provided emergency care, drug therapy and surgical intervention reduce the number of complications to a minimum. An experienced traumatologist, after making a diagnosis, already has a clearly planned course of treatment.
First aid for injury
First aid is an important stage in the treatment of any pathology. The activity of restoration processes and the correct fusion of bone fragments depend on the quality and speed of its provision.
- Anesthetizes the affected limb and reduces swelling. For this purpose, many people use a heating pad with ice or a cold compress. It will also not be superfluous to take a tablet of any painkiller from your home medicine cabinet: Analgin, Ketanov, Diclofenac.
- Apply a tight bandage above the fracture site if there is bleeding (this position is necessary to prevent displacement).
- Immobilization of the injured finger. It is produced by fixing it to a tire, which is constructed from available materials, for example, a solid wooden ruler.
- Contact the trauma department of the hospital.
The damaged finger must be fixed in a motionless state.
However, some actions of an unprepared person can lead to disastrous consequences: the assistance provided will only worsen the patient’s condition. To avoid annoying mistakes and keep the limb in good condition, it is recommended to follow simple first aid rules.
- independently try to set broken bones inside the wound canal;
- sharply rotate, bend and straighten the injured finger - there is a possibility of displacement of fragments;
- bandage the finger tightly if there is no bleeding: poor circulation can lead to gangrene;
- take medications without a doctor’s prescription: the maximum that can be taken is a painkiller tablet, because many drugs can blur the overall picture of the injury.
- transport the patient without transport immobilization: there is a high risk of bone displacement.
Further therapy
For uncomplicated closed fractures, conservative treatment is used. To begin with, bone fragments are repositioned under X-ray control. They are placed in the correct position, which promotes further healing. Immediately after reposition, the finger is cast or placed in a special fixator, which will support it throughout the entire treatment period.
Wearing a cast is often accompanied by the appearance of bone bedsores, so fixators are now more often used. The Belara splint is also a good alternative to a plaster splint. The duration of wearing these structures is from one to two months.
Application different techniques finger fixation promotes better healing
The following groups of drugs are used for drug therapy:
- Anti-inflammatory drugs - help reduce swelling and improve blood supply to tissues. For this purpose, Ibuprofen, Meloxicam, Nimesulide and Diclofenac are used.
- Painkillers. Prescribed to all patients during the first weeks after the fracture. Analgin, Piroxicam and Amidopyrine reduce the intensity of pain several times.
- Immunomodulators. Help to activate immune system body, helping it prevent bacterial infection in the bone. Currently, Taktivin, Timalin, and Levamisole are used.
Diclofenac is a non-steroidal anti-inflammatory drug, often used for fractures, it helps reduce pain and relieving inflammation
Surgical treatment (operation)
In cases complicated by a displaced fracture, it is necessary to resort to surgical intervention. Any operation is stressful for the body, so there are strict indications for which it is performed.
Indications for surgical intervention:
- open fracture with displacement of fragments;
- closed fracture with displacement of fragments;
- intra-articular fracture;
- improper healing of an old fracture;
- comminuted fractures of various locations.
The operation is carried out in several stages. First, the wound is cleaned of contaminants and small bone fragments and damaged tissue are removed. Then the surgeon mobilizes the bone fragments and performs osteosynthesis: using small screws, a metal structure is inserted into the distal areas of the bone, which ensures reliable alignment of the fragments and replaces the bone defect before the formation of a callus. The final stage of the operation is suturing the wound and radiological monitoring of the intervention.
In cases where the bones begin to heal incorrectly, repositioning is performed. To do this, they are subjected to mechanical stress, forming another fracture. This operation is performed under local anesthesia.
After the correct fracture line has been formed, the wound channel is closed and a splint is applied to prevent displacement of the fragments.
Traditional medicine
Traditional methods for fractures are more likely auxiliary than a full-fledged medicine. Most of the advice is aimed at increasing calcium levels in the body and activating recovery processes.
Traditional methods should be used only after consultation with a specialist and in compliance with the basic treatment plan. You should not self-medicate or try to fix the fracture yourself.
The best recipes for bone tissue restoration:
- Onion broth. Helps activate the body's immune system. To prepare it, two or three fresh onions are used. They need to be fried in vegetable oil for twenty minutes. The resulting pulp must be boiled in hot water to a boil. The decoction should be consumed one glass a day before meals.
- Crushed chicken egg shells. It's no secret what the shell contains large number calcium, so necessary for the normal functioning of bone tissue. The shells of two eggs should be crushed to a powder and added to food one teaspoon at a time.
- A mixture of walnuts with honey and lemon juice. Promotes the formation of new bone cells and has an anti-inflammatory effect. Two tablespoons of honey should be mixed with crushed walnut by adding a few drops of lemon juice. The resulting mixture is consumed twice a day after meals.
For normal bone tissue restoration, calcium is needed, which is so abundant in the shells of chicken eggs.
What to do if your finger is broken - video
Rehabilitation
The most important period after an injury is rehabilitation. After prolonged immobilization, the finger, and sometimes the entire hand, loses its functional abilities.
Many people are concerned about how long recovery takes. Properly selected exercises and strict adherence to medical recommendations will allow the injured finger to return strength within a few weeks. The basic rehabilitation course is selected by a traumatologist, and extended activation measures are carried out by a rehabilitation specialist.
Rehabilitation takes place in three main directions:
- Therapeutic gymnastics. It is recommended to use power expanders or just small rubber balls. They need to be compressed and unclenched at regular intervals at least ten times a day. Simple exercises on flexion-extension and abduction-adduction of a broken finger will also be useful. To develop fine motor skills, you can use small glass balls or ordinary buttons: transferring them from one container to another will have a beneficial effect on the function of the hand.
- Massage. You can either sign up for a massage course with a specialist or conduct it at home. Massaging must be done regularly. It should begin with the tips of the fingers and end with middle third forearms. This promotes blood circulation in the injured limb, activating healing processes. At first, the movements should be very smooth and soft, after several days you need to increase the pressure. The duration of the massage is on average fifteen to twenty minutes. The course lasts about a month.
- Physiotherapeutic activities. The procedures begin immediately after the plaster is removed. Magnetic therapy and light therapy eliminate swelling and relieve the intensity of pain. Electrotherapy has a stimulating effect, activating the synthesis of bone tissue cells. The amount and duration of exposure is determined by the degree of fracture and the time of immobilization.
- Hypertrophied callus. In response to the irritating stimulus, the bone begins to grow with a vengeance, resulting in the formation of a huge defect. Besides the unpresentable appearance, this complication brings a lot of inconvenience in everyday life.
- False joint. It is a pathological formation that allows you to bend your finger in a place where such movements should not occur. The main reason for its formation is insufficient immobilization of the finger. Treatment is carried out surgically.
- Abnormal bone fusion. If no reduction was carried out during a displaced fracture, the bones may heal incorrectly: a callus forms on the lateral surface of one of the fragments. The normal functioning of the fingers is significantly hampered, which is why it is necessary to resort to surgical correction of the problem.
- Contracture. With prolonged immobilization of the finger in a physiological position, shortening of the ligaments and tendons of the hand occurs. The function of the flexors is impaired, and the finger becomes frozen in one position. Therapeutic gymnastics is actively used to prevent contractures.
- Ankylosis of articular surfaces. When the joint ossifies, a decrease in the mobility of the bones relative to each other develops. This complication is very difficult to treat and leads to disability of the patient.
- Osteomyelitis is an inflammatory disease that is a bacterial focus of infection in the bone. Accompanied by intense pain and a rise in temperature to subfebrile levels. The disease is dangerous due to its generalization, which can lead to sepsis and death.
- Numbness. Often, fractures injure the nerve plexuses and blood vessels that feed the tissue. As a result, the finger may become numb. For some, this feeling is temporary, after which sensitivity is restored. For some, finger numbness becomes a constant companion throughout their lives.
The doctor selects individual program recovery taking into account the gender, age and health status of the patient. If these activities are carried out regularly, rehabilitation lasts one and a half to two months, and after six months, many completely forget that they once broke their finger.
Prognosis and possible complications
A broken finger is an injury that does not threaten human life. However, for many people, their hands are a source of income: artists, architects, musicians and surgeons have a hard time with temporary disability. With a timely diagnosis, strict adherence to the timing of wearing a cast and rehabilitation, the injury heals without any noticeable consequences. If there were complications during the treatment, this can lead to various complications. The most common of them are:
Preventive measures
To avoid finger injuries, you must follow simple safety rules. When engaging in unsafe sports, as well as when performing repair work, it is necessary to use protective gloves or special protectors that reduce the impact on the hand. If the cause of the fracture is a chronic disease associated with increased bone fragility, it is recommended to undergo treatment from a doctor.
Unfortunately, it is impossible to completely minimize the risk of injury. All a person can do in this situation is to reduce the likelihood of injury. And if a fracture occurs, consult a specialist to avoid unpleasant consequences.
Any fracture is a good reason to consult a traumatologist. When using only home remedies and methods traditional medicine Serious complications may occur, leading to impaired hand function. IN severe cases malunion may result in re-fracture or even amputation of the finger. It is worth taking all precautions to avoid such an outcome in any situation.
Fracture is a violation of the linear integrity of the bone under the influence of a force exceeding the tensile strength of the bone. The main cause of fractures in the world is trauma. It ranks third in disease statistics.
Finger fracture is a serious pathology, despite the small size of this part of the body. According to statistics, finger fractures account for 5% of all fractures. Finger fractures are considered severe injuries to the hand, as they significantly reduce its functionality.
Diagnosis of a broken finger, as a rule, does not cause difficulties, but with treatment the situation is different. To completely restore the shape and function of the bone, you must strictly follow all recommendations for the treatment of this pathology. Deviation from treatment requirements leads to serious complications and even disability.
Anatomy of the hand
The human hand is an extremely complex formation, from an evolutionary point of view. It consists of 30 - 32 bones of various shapes and functions with the help of numerous tendons and muscles arranged in layers. The complex organization of the hand allows movements around all three axes. The fingers are topographically related to the hand and significantly increase its functional load. Despite the fact that their bony skeleton allows movements only in one plane, and the radius of movement does not exceed 180 degrees, thanks to the articulation with the hand, the fingers also acquire the ability to make adducting and abducting movements. This organization of the hand significantly increases the range of movements and their accuracy.
Bones and joints of the hand
Topographically, the boundaries of the hand extend from the line connecting the styloid processes of the ulna and radius. Visually, this line crosses the far part of the forearm at the point where a small bony tubercle protrudes on its dorsal surface.The brush consists of three sections:
- wrist;
- metacarpus;
- fingers of the hand.
The wrist normally consists of 8 bones arranged in 2 rows. Proximal ( near) row consists of four bones, forming a kind of semicircle, which is the articular fossa for articulation with the bones of the forearm. These bones include the scaphoid, lunate, triquetrum, and pisiform. The second row also consists of 4 bones, which articulate with the bones of the first row on the proximal side, and on the distal side ( distant) – with metacarpal bones. Among the bones of the second row, there are the trapezoid, trapezoid, capitate and hamate bones. Rarely, x-rays will reveal an additional ninth bone, called the central bone.
Pastern
The metacarpus consists of five tubular bones, slightly curved with a convex outward. All these bones have an oblong triangular body ( diaphysis) and two epiphyses ( end). The proximal epiphyses are thicker than the distal ones and form articular fossae for articulation with the distal row of carpal bones. The distal epiphyses are thinner and form articular heads for articulation with the proximal phalanges of the fingers. On the sides of both the proximal and distal epiphyses there are articular surfaces for connecting the metacarpal bones to each other.
Fingers of the hand
All fingers, with the exception of the thumb, consist of three phalanges - proximal, middle and distal. The thumb lacks the middle phalanx. Each phalanx is a small tubular bone with a body and two ends. Unlike the bones of the metacarpus, the phalanges have only one true epiphysis - the proximal one, and the distal end of the bone does not form an epiphysis. The epiphysis of the proximal phalanges is concave and articulates with the heads of the metacarpal bones. The epiphyses of the middle and distal phalanges are two articular fossae separated by a ridge. The distal ends of all phalanges are flattened and form block-shaped articular heads for articulation with the articular surfaces of the proximal epiphyses of the phalanges. This shape of the joint eliminates lateral movements of the fingers and allows only flexion and extension of the fingers. The distal phalanx gradually narrows and ends with a tuberosity for the attachment of muscle tendons.
In cross-section, the phalanx of the finger is an oblong bone with a canal in the center containing the bone marrow. There is a thin layer of spongy substance around the canal. The spongy substance, in turn, is surrounded by a dense compact substance, which gives the bone density. The diaphysis of the bone is covered with periosteum, rich in blood vessels and nerves. The periosteum is responsible for the growth of bone in width. The ends of the bones are covered with a layer of hyaline cartilage, which has less friction compared to the periosteum and performs a shock-absorbing function ( those. shock mitigation). The small strip of bone tissue located between the epiphyses and diaphysis is called the metaphysis. It, in turn, corresponds to the growth zone responsible for bone growth in length.
Ligamentous apparatus, muscles and their innervation
Due to the fact that there are at least 20 names of hand ligaments, it would be most logical to cover only those ligaments and tendons that are directly related to the work of the fingers.Among the ligaments of the fingers, it is necessary to distinguish only the collateral ones. At one end they are attached to the lateral surfaces of the heads of the metacarpal bones, and at the other to the lateral sides of the proximal phalanges. The interphalangeal joints, like the metacarpophalangeal joints, have their own collateral ligaments, which, like the first ones, are attached to the sides of the articular surfaces above and below the phalanges. The main function of these ligaments is to strengthen the joint capsule and ensure movement in the joint only within permitted physiological limits. Thus, the collateral ligaments prevent dislocation of the metacarpophalangeal and interphalangeal joints during pathological lateral flexion of the finger.
The muscular system of the hand is responsible for the movements of the fingers. It is conventionally divided into the muscles of the palmar and dorsal surface. The muscles of the palmar surface, in turn, are divided into 3 groups - the muscles of the eminence of the thumb, the muscles of the eminence of the little finger and the middle group of muscles. A description of the shape of the muscles, their locations and places of attachment will be omitted due to the complexity and high specificity of this material. If desired, this information can be found in any anatomical atlas. The main emphasis will be on the functions of each muscle, since the absence of certain movements during a fracture of the fingers can be used to judge the nerve that is damaged. Also, only those hand muscles that are directly responsible for finger movements will be listed. The remaining muscles of the hand will be lowered.
The following muscles of the eminence of the thumb are distinguished:
- abductor brevis muscle thumb brushes;
- muscle that opposes the thumb;
- flexor pollicis brevis;
- adductor pollicis muscle.
This muscle performs abduction, slight opposition of the thumb ( movement towards the little finger), and also partially flexes the thumb. This muscle is innervated by the median nerve.
Muscle that opposes the thumb to the hand
The muscle moves the thumb towards the little finger. This muscle is innervated by the median nerve.
Flexor pollicis brevis
The muscle produces flexion of the proximal phalanx of the thumb. Its innervation is carried out partially by the median and ulnar nerve.
Adductor pollicis muscle
The function of this muscle is to move the thumb towards the proximal phalanx of the index finger ( casting) and partial flexion of the proximal phalanx of the thumb. The muscle is innervated by the ulnar nerve.
The following muscles of the eminence of the little finger are distinguished:
- abductor digiti minimi muscle;
- flexor of the little finger;
- muscle opposite the little finger.
The muscle produces movement of the little finger to the ulnar side, as well as flexion of its proximal phalanx. Its innervation is carried out by the ulnar nerve.
Flexor digiti brevis
The muscle flexes the little finger and is partially involved in its adduction. Innervation is carried out by the ulnar nerve.
Opponus little finger muscle
The muscle moves the little finger towards the thumb. Innervation via the ulnar nerve.
Distinguish between muscles middle group palms:
- vermiform muscles;
- palmar interosseous muscles.
Four small fusiform muscles flex the proximal phalanges of all fingers except the thumb and extend their middle and distal phalanges. The two muscles on the side of the elbow are innervated by the ulnar nerve, and the remaining two muscles by the median nerve.
Palmar interosseous muscles
The muscles are responsible for flexing the proximal phalanges of four fingers except the thumb and bringing them to center line, that is, reduction into a bundle. Innervation is provided by the ulnar nerve.
The muscles of the dorsum of the hand are represented by the dorsal interosseous muscles in number of four. Two extreme elbow muscles pull the middle and ring fingers towards the little finger. The two outermost muscles on the side of the radius pull the index and middle fingers towards the thumb. At the same time, all four muscles flex the proximal phalanges of all fingers except the thumb and extend their middle and distal phalanges.
Causes of finger fractures
The most common cause of finger fracture is trauma, and the mechanism of injury is correspondingly direct. An indirect fracture mechanism is present in the rare case when a force acts on different ends of the phalanx, under the influence of which a fracture occurs not in the places of compression, but in the middle of the bone. As a rule, all finger fractures occur at home or at work. In wartime, the frequency of finger fractures practically does not change, which, in principle, is not typical for fractures of other bones. Pathological fractures of the fingers due to metastases of a malignant tumor in the phalangeal bone are theoretically possible, but in practice they are an extreme case. Finger fractures are clinically divided into open and closed. A fracture is considered closed when the skin over the fracture site remains intact. Accordingly, an open fracture is characterized by damage to the skin of the finger by sharp bone fragments. Despite the fact that the phalanges are tubular bones that can form sharp ends when fractured, more often than not this does not happen and the fracture remains closed. Presumably this is due to the small size of the phalanges and insufficient leverage to damage the sufficiently strong skin of the fingers from the inside. However, if an open fracture of the finger does occur, then the risk of a complication such as osteomyelitis - inflammation of the bone marrow - increases significantly.
Both closed and open fractures of the phalanges are divided into fractures with and without displacement of bone fragments. Displaced fractures, in turn, are divided into fractures with divergence of bone fragments and overlap of the edges of bone fragments.
Based on the number of bone fragments, the following types of fractures are distinguished:
- splinter-free;
- single-splintered;
- two-splintered;
- comminuted ( fragmented).
- longitudinal;
- transverse;
- oblique;
- S-shaped;
- screw;
- T-shaped, etc.
Symptoms of a broken finger
Symptoms of a finger fracture are generally identical to fractures in other locations. They are conventionally divided into probable signs of a fracture and reliable ones. Possible signs of a fracture include:
- local swelling at the fracture site;
- pain over the fracture site;
- gentle finger position;
- redness at the fracture site;
- warmer skin over the fracture site compared to the surrounding skin;
- inability to move a finger;
- pain when trying to press on its top.
- palpable disruption of bone continuity ( crack);
- visual change in bone shape;
- pathological bone mobility where it should not be;
- bone crepitation ( crunch) when trying to displace bone fragments;
- visual shortening of the broken finger in relation to the healthy finger of the other hand.
Diagnosis of a finger fracture
Diagnosis of a finger fracture is made according to the above clinical signs. To confirm the diagnosis, an x-ray of the hand or individual finger is taken in frontal and lateral projection. This approach allows not only to determine the presence or absence of a fracture, but also to clarify its exact location, shape and depth. This information turns out to be extremely useful when choosing a treatment method for a patient. Theoretically, more modern methods can be used to diagnose a finger fracture, such as computed tomography, but in practice this is never done for two reasons. Firstly, computed tomography is a rather expensive study, and secondly, a simple x-ray in two projections is usually enough to understand what kind of fracture the patient came with and what treatment approach is most appropriate.
It is important to remember that x-rays of the finger must be repeated after removal of the cast in order to monitor the quality of bone fusion and the correct position of the intraosseous fixation devices.
First aid for suspected broken finger
Providing first aid is the first step in treating a patient with any pathology. How successful the treatment as a whole will be depends on the correctness of measures aimed at alleviating the patient’s condition. A finger fracture is no exception, so first aid will focus on several tasks - eliminating pain, immobilizing the upper limb and combating complications. Do I need to call an ambulance?
Many people believe that a broken finger is not a sufficient reason to call an ambulance and, in principle, to seek qualified medical help. Unfortunately, many of these people are mistaken. It is necessary to call an ambulance for the following reasons.The pain syndrome from a broken finger can be insignificant, or it can be so pronounced that it can only be compared with toothache, which is rightfully considered one of the most severe pains. Pain is a factor that may well cause a state of shock, manifested by a sharp drop in blood pressure, sometimes even to zero values. In addition, pain itself promotes the release of biologically active substances into the blood that support inflammation and ultimately increase pain, closing a vicious circle.
In order to reduce pain, the arsenal of emergency medicine contains various painkillers, from the weakest in their effect to the most powerful ones existing today. With a decrease in pain, the activity of the development of the inflammatory process decreases, not to mention the suffering of the patient himself.
Often a fracture of a finger is accompanied by a gross deformation of the usual shape of the finger and is accompanied by deep scratches and abrasions. In this case, doctors or paramedics can clean, disinfect the wound and apply devices to immobilize the fracture.
It is rare, but it happens that the digital artery or one of the digital veins is injured by fragments of broken phalanges. In this case, quite massive bleeding develops, which cannot always be stopped by simply pressing on the bleeding vessel, and even more so if there are several damaged vessels. Emergency workers are trained to stop bleeding by applying a special tourniquet to areas where the main blood vessels supplying the arm lie close to the bone.
What is the best position to hold your hand?
When a finger is broken, there is no specific position in which it is recommended to hold it. The main rule in this case is to ensure the immobility of the broken finger in the position in which it is in a relaxed state. As a rule, if the finger does not change its position, then the pain in it remains at an average level, that is, relatively tolerable.It will also be useful to support the entire upper limb with a bandage or improvised splint. This is done to reduce the mobility of the hand on which the broken finger is located, and, accordingly, to reduce the likelihood of even accidentally touching surrounding structures with the finger. It is also useful to gently pull the shoulder and forearm towards the body using special bandages such as Velpeau and Deso. This manipulation further immobilizes the hand and protects the broken finger.
Is it necessary to give painkillers?
As stated earlier, pain provokes the development of inflammatory processes in damaged tissues, and the inflammatory process leads to increased pain. Accordingly, a vicious circle is formed that must be interrupted to reduce the progression of inflammatory symptoms. To this end, it is necessary for the victim to take either a pain reliever or an anti-inflammatory drug as soon as possible after the injury.At home, the most common anti-inflammatory and painkillers are:
- ibufen;
- meloxicam;
- nimesil et al.
Is immobilization necessary?
In this case, immobilization means temporary immobilization of the fracture site in order to prevent increased pain and the development of complications. This type of immobilization is called transport immobilization, since it is during transportation to a hospital or injury point that there is a high risk of secondary damage to broken phalanges.As stated above, there is no specific position in which a broken finger needs to be fixed. It is important to fix it in the position in which the patient feels the least pain with relaxed hand muscles. To reduce the risk of accidental injury to a finger, it is necessary to immobilize the entire arm and, if possible, keep it close to the body.
As a rule, with a simple closed fracture, immobilization is not applied to the finger itself. However, with complex comminuted fractures, there is sometimes a need for immobilization. Immobilization can be achieved mainly in two ways.
The first method is to apply a narrow and long splint, which can be a stick of medium thickness or a wire 30–40 cm long. One end of the splint is fixed at the broken finger, protruding 2–4 cm beyond its top. The second end rests on the palmar surface of the hand and forearm and is fixed. Then, using a bandage, carefully wrap the arm along with the splint, starting from the elbow edge and slowly moving until the hand and finger are hidden under the bandage.
The second method is simpler, but less effective. It involves tying the broken finger to an adjacent or several adjacent fingers. This fixation method is most suitable for closed finger fractures without displacement of bone fragments.
Do I need to apply cold?
Cold is the first pain reliever and anti-inflammatory agent used by humans. The mechanism of its action is to reduce the temperature of tissues and pain receptors located in them. The latter are able to perceive irritations in the temperature range from 4 to 55 degrees. Accordingly, when the temperature of the nerve receptor decreases to less than 4 degrees, its activity slows down until it stops completely.The mechanism of action of cold differs from the mechanism of therapeutic action of painkillers and anti-inflammatory drugs. Therefore, cold can be safely combined with medications. It is most convenient to use ice for this purpose. Moreover, it is desirable that the ice be crushed and placed in a waterproof bag or heating pad. Crushed ice takes the shape of the area of the body it is applied to much better. As a result, the area of contact between the skin and ice increases and faster and better pain relief occurs at the fracture site.
It is important to remember that extremely low temperatures affecting living tissue for a long time can lead to frostbite. In order to avoid such a complication, it is necessary to remove the ice pack every 5 - 10 minutes for 2 - 3 minutes.
Treatment of a fractured finger
Treatment of a finger fracture is carried out using various methods, depending on its complexity and associated complications. Traditional methods of treating a broken finger are:
- one-stage closed reduction;
- skeletal traction methods;
- open reduction.
One-stage closed reduction
Simultaneous closed reposition of bone fragments is carried out for simple closed fractures with displacement. The classic displacement of fragments in such a fracture occurs towards the palmar side, that is, at an angle open to the back of the hand. Closed reduction is carried out in several stages. First, a test is made to determine the patient's tolerance to a local anesthetic. More often, medium concentrated solutions of procaine and lidocaine are used for this purpose. In the absence of an allergic reaction to the anesthetic, it is gradually injected into the tissue surrounding the fracture. When pain relief is achieved, traction is performed ( traction) finger along its axis. Then slowly bend all the joints of the finger until an angle of approximately 120 degrees is achieved. After this, pressure is applied to the angle of the fracture until the bone returns to its original position, and then it is fixed. Immobilization is carried out with a plaster splint from the upper third of the forearm to the base of the fingers. Subsequently, only the damaged finger is fixed in a partially bent position, while the rest remain free. Immobilization of healthy fingers is considered a mistake because it leads to the development of ankylosis ( shortening and hardening of the ligamentous apparatus, preventing full movement of the limb). Upon completion of the manipulation, the patient is recommended to keep the limb in an elevated position for 2 to 3 days to reduce swelling, and also take painkillers in medium dosages indicated in the attached instructions.
Skeletal traction methods
This method of treatment is used for comminuted closed fractures or when, after one-step reposition, it is not possible to fix the bone in the correct position. As in the previous case, a test is carried out to determine the tolerance of the anesthetic substance. In the case when it turns out to be negative ( no allergic reaction develops), the same splint is applied to the forearm and hand as in the previous treatment method, but with one modification. A strong wire is attached to its palmar surface opposite the broken finger, extending several centimeters beyond the top of the finger and ending in a hook or loop. Reposition of fragments is carried out in a similar way, with the same anesthesia, only after this the finger is stretched using a thread, pin or staples passed through the soft tissue of the finger or nail phalanx. For a more durable fixation of the structure, the nail is covered with several layers of polymer varnishes, which are used in cosmetology for nail extensions. After the manipulation, the patient is prescribed a preventive course of antibacterial, anti-inflammatory and analgesic treatment.
Open reduction
This treatment method is the last one that doctors resort to for broken fingers. The fact is that open reposition, in essence, is a surgical intervention on an open bone and is accompanied by all the complications characteristic of operations in principle - wound suppuration, suture failure, osteomyelitis, etc. However, for certain indications this method is the only possible treatment for finger fractures. Typically, these indications include an open simple or comminuted displaced fracture, a malunion fracture requiring bone destruction and repositioning, and purulent complications of previous treatment methods. This procedure is carried out according to all the rules of a full-fledged surgical intervention under general anesthesia. Fixation of bone fragments is carried out more often with knitting needles, less often with screws. External fixation device ( Ilizarov apparatus) can also be used for a broken finger. Its advantage is that it reliably fixes bone fragments and does not require the application of plaster, which prevents the wound from rotting and the development of suppurative processes in it. However, the disadvantage of the Ilizarov apparatus is that it requires careful daily treatment, since it itself is a foreign body and a potential source of an inflammatory reaction.
Is it necessary to apply plaster?
Proper treatment of finger fractures always involves applying a cast. A finger fracture is a fracture of high complexity, so treatment should be taken as seriously as possible. In order to achieve best results it is necessary to reliably immobilize the fracture site. The most common material for applying an immobilizing bandage is a bandage soaked in a concentrated plaster solution. When dried, the plaster takes the shape of the limb and for a long time retains the necessary structural rigidity to ensure the required level of immobilization. In addition to plaster, there are other substances used to fix the upper limb for fractures of the fingers. We are talking about special polymers that are applied like a plaster cast, but without using a bandage. After drying, the strength of the polymers is not inferior to gypsum, and the weight of the structure is several times less. In addition, when using it, there is no need to protect this material from liquid ingress, as when using gypsum, which is destroyed in this case. It goes without saying that modern polymer materials for immobilization are not available in every hospital. In addition, they are most often not covered by the health insurance policy and must be paid for from the patient’s budget.
As mentioned above, when a finger is broken, plaster is applied starting from the near part of the forearm, moves to the hand and ends with a separate fixation of only the broken finger. In this case, it is important to initially take care of the correct position of the brush, since once the plaster hardens, it will no longer be possible to change it. Correct position the hand involves extension of the wrist joint by approximately 30 degrees and flexion of the phalanges of the fingers ( if skeletal traction methods were not used) until the tops of the fingers lightly touch the palm. This position of the hand ensures the prevention of repeated displacement of bone fragments, as well as the prevention of contractures. If contractures do develop, this position of the hand allows you to maintain its grasping function.
How long is a cast needed?
For simple closed fractures of the fingers without displacement, the duration of plaster immobilization is on average 2–3 weeks. Full restoration of ability to work occurs in 3–4 weeks.For fractures of moderate complexity, namely closed simple and comminuted fractures with displacement, as well as fractures requiring skeletal traction, plaster is applied for an average of 3 - 4 weeks with restoration of working capacity for 6 - 8 weeks.
For complex open comminuted fractures using osteosynthesis methods ( restoration of bone integrity using the implantation of wires, screws, etc.) the period of wearing a cast sometimes reaches 6 weeks, and full restoration of the finger’s ability to work occurs in 8–10 weeks.
Complications of self-treatment of a finger fracture
The treatment of finger fractures should be approached with all responsibility, since careless treatment often leads to the development of complications. Some of them cause the patient many times more inconvenience and even suffering than the fracture itself. The most common complications of self-treatment of a finger fracture are:
- formation of a large bone callus;
- formation of a false joint;
- formation of contracture;
- formation of ankylosis;
- improper bone fusion;
- osteomyelitis, etc.
The formation of callus is a normal physiological stage of the healing of any fracture. However, if bone fragments are incorrectly displaced, a giant bone callus is formed. Its development occurs as a compensatory reaction of the body. In other words, the body is interested in restoring the strength of the damaged bone, but if the fragments are not aligned correctly, the axis of the bone also changes. Along with the change in the axis, the maximum permissible load on the bone. In order to compensate for the loss of functional load, the bone is forced to strengthen the fracture site more strongly, resulting in the growth of callus. In addition to an aesthetic defect, callus often limits the movement of the finger, reducing its participation in the activity of the entire hand.
Pseudarthrosis formation
A false joint is a place where there is free flexion of a limb where normally there should be no flexion. False joints form when closed fractures of the phalanges are not sufficiently immobilized. As a result, the movement of bone fragments at the fracture site continues and their gradual rubbing against each other. Over time, the sharp ends become blunt and even rounded, and the bone canal becomes overgrown. At a certain point, one solid bone becomes two shorter bones, with a small gap between them. It is thanks to this gap that movement between fragments of the once intact bone is maintained.
Unfortunately, the false joint is functionally incompetent, painful and is a constant source of inflammation in the body. The annoying thing is that the treatment for this complication is only surgical and consists of destroying the edges of the false joint and re-combining the bone fragments. The success of such an operation is always questionable due to the fact that after it a large bone callus is formed, the bone, and therefore the limb, is shortened and the risks of developing a secondary iatrogenic ( caused by medical procedures) osteomyelitis.
Formation of contracture
Contracture is the shortening of the tendons and ligaments of a limb or a certain part of it due to inflammation or prolonged inactivity. In case of a fracture of a finger due to incorrect position of the hand during immobilization of the upper limb, uneven tension of its tendons occurs. Some tendons become tense, others relax and shorten over time. After removing the plaster, those tendons that were stretched do not interfere with movements in the joint, and those that have shortened do not allow voluntary movements in the direction opposite to the ligament. Treatment of contractures is long and painful, as it is associated with daily stretching of the shortened tendons.
Formation of ankylosis
Ankylosis is the fusion of the articular surfaces of a certain joint and the formation of solid bone at the joint site. This complication can develop when a fracture involves a joint and is not treated appropriately. As a rule, most patients become disabled for life because effective treatment This complication does not exist today.
Incorrect bone fusion
For open fractures and closed fractures with displacement, a mandatory stage of treatment is repositioning of bone fragments. Reposition means the return of bone fragments to their original physiological position. In the absence of reposition of fragments, poor-quality reposition or weak immobilization, displacement of one of the bone fragments occurs ( more often distal) away from the correct axis. When the bone is kept in this position for several weeks, the fracture heals, and the distal fragment remains in place forever. incorrect position. In addition, a large bone callus forms, preventing normal movement of the finger.
Osteomyelitis
Osteomyelitis is the development of inflammation of the bone marrow. A distinction is made between primary hematogenous osteomyelitis, in which pathogenic bacteria are introduced into the bone marrow through the blood, and secondary traumatic or iatrogenic osteomyelitis, in which bacteria enter the bone marrow from surrounding objects and the atmosphere during injury or surgery. With an open fracture of the finger, the development of secondary osteomyelitis is most likely due to the absence or insufficiency of primary wound treatment. This disease is very painful and often becomes chronic with frequent phases of exacerbation. As a rule, exacerbation occurs after the bone has fused. Inflammation increases pressure in the bone canal of the phalanges of the fingers and bursts the bone and the surrounding periosteum from the inside. The pain is so severe that it can only be reduced by large doses of opiates ( morphine, omnopon), and patients sometimes even beg to have the painful part of their body amputated.
Treatment is exclusively surgical and temporary. In some cases, in order to reduce pressure in the medullary canal, small holes are drilled, the canal is drained and washed for a long time with solutions of antiseptics and antibiotics, after which the access is closed. However, in some cases, when the bone heals, osteomyelitis relapses ( reoccurs). In other cases, after removing the purulent contents of the bone marrow canal, a part of the nearby muscle is placed in it and the wound is sutured. In this way, the frequency of relapses of osteomyelitis is reduced, but complications arise associated with the multi-stage nature and technical difficulties of performing this surgical intervention.
How long is the recovery period after surgery?
The type of surgical treatment for a finger fracture largely influences the duration of the recovery period. In addition, purulent complications have a great influence, which can cause multiple re-operations aimed at cleansing the purulent focus. An important factor influencing the rate of recovery after surgery is the patient’s age and concomitant pathologies. Thus, in children, the rate of bone fusion and tissue regeneration is the highest. In people under 40 years of age, the recovery rate remains fairly high level, and then slowly decline every year. Among the diseases that cause slower bone regeneration and connective tissue include diabetes mellitus, hypothyroidism, parathyroid tumor, etc. Osteosynthesis using wires and screws can be either one-stage or two-stage. With one-stage osteosynthesis, the fixation devices remain in the patient’s bone for life, and with two-stage osteosynthesis, they are removed 3–4 weeks after injury through repeated minimally invasive surgical access. Accordingly, with one-stage osteosynthesis, the recovery period lasts on average 4–6 weeks, and with two-stage osteosynthesis it extends to 7–8 weeks.
Osteosynthesis using a device for external fixation of bone fragments is always a two-stage process. In addition, its use increases the risk of septic complications, which can also delay recovery. Based on the above, with a successful healing of the fracture, the recovery period for working capacity is on average 6–8 weeks. With constant moderate inflammation, recovery time is delayed by 1 to 2 weeks. In case of severe inflammation and suppuration of the wound, it may be necessary to re-open the wound and cleanse the purulent focus. In this case, full recovery is delayed by 4 to 6 weeks and may ultimately take 10 to 14 weeks.
In the case of rupture of ligaments or muscle tendons and their suturing during surgery, in the recovery period, as a rule, there is a significant shortening of them. As a result, after healing of the fracture, the patient is not able to fully use his fingers, since their mobility is limited. Tendon development can also take up to two weeks, which must be added to the time the plaster immobilization is removed. On average, the period of complete recovery is 6–8 weeks, depending on the severity of the fracture itself.
What physical procedures are indicated after a fracture?
Physiotherapy greatly helps speed up the treatment process for any fracture. The physiotherapeutic effect is based on the influence of natural factors on the bone and the influence on the rate of metabolic processes in it. The positive effect of physiotherapy is manifested in analgesic, anti-inflammatory, decongestant, myostimulating, trophic and other positive effects. Physiotherapy for a broken finger
| Type of procedure | Mechanism of therapeutic action | Duration of treatment |
| UHF (ultra high frequency therapy) | Deep heating of bone and surrounding soft tissue muscle tissue. Acceleration of metabolic and regenerative processes. Improving blood supply and tissue oxygenation. Moderate anti-inflammatory and analgesic effect. Relaxation of the smooth muscles of blood vessels. Acceleration of callus formation. | Starting from 3 days after reposition of fragments. 10 – 15 procedures. Daily. The duration of the procedure is 10 – 15 minutes. At low radiation intensity there is an anti-inflammatory effect. With moderate intensity radiation, metabolic processes are predominantly stimulated. |
| Therapeutic gymnastics | It is performed only on healthy fingers to prevent contractures. Improving microcirculation and blood supply to tissues. Maintaining optimal levels of cellular metabolism. | From 3 days after reposition of fragments. Daily. 10 – 20 procedures. The duration of the procedure is 5 – 10 minutes. |
| Warm baths with soda and salt | Analgesic effect by reducing the sensitivity of pain receptors. Pronounced anti-inflammatory effect aimed at joints and bones. Relaxation of vascular smooth muscle. Improving blood supply to tissues. Moderate fibrinolytic effect aimed at softening ligaments and treating ankylosis. | Apply starting from the day the plaster is removed. 12 – 15 procedures. Daily or every other day. The duration of the procedure is 10 – 15 minutes. Water temperature is within 35 – 39 degrees. |
| Exercise therapy | Development of contractures of the elbow, wrist and hand joints. Reorganization of connective tissue of ligaments and tendons. Stretching of the joint capsule. | Apply starting from the day the plaster is removed. 15 – 20 procedures. Daily or every other day. The duration of the procedure is 15 – 20 minutes. |
| Ozokerite applications | Superficial and deep heating of tissues. Vasodilator effect. Improving the metabolism of bone and muscle tissue. Reflex effect on nerve centers. Increasing the body's resistance to aggressive factors. | 3 – 5 days after removal of the plaster. 8 – 10 procedures. Daily. The duration of the procedure is 10 – 15 minutes. |
| Mechanotherapy | Restoration of thin motor activity and sensitivity through various manipulations of small objects. Restoration of coordinated muscle work after a long period of rest. | After removing the plaster. 15 – 30 procedures. Daily. The duration of the procedure is 15 – 20 minutes. |
Fractured fingers are a fairly common occurrence. Such injuries account for about 10% of the total number of fractures. A fracture of the fingers requires long-term rehabilitation after the bone heals - the hands and feet need to be developed so that they retain their beauty and mobility. Let's learn how to develop a finger after a fracture.
Development of fingers after a fracture
Treatment of a fractured finger involves limiting its mobility. The bandage or plaster is worn for no more than a month - during this time the bones should heal and the pain should disappear completely.
Fingers fixed in one position for a long time lose their mobility, which limits our capabilities and is a cosmetic defect. After removing the cast, under no circumstances should you immediately load your arm; long-term and gradual rehabilitation is necessary.
The further condition of your hand will depend on how seriously you approach restoring the motor function of your fingers.
By training, developing your hand, you can avoid such phenomena as:
- mobility impairment
- appearance of callus
- post-traumatic polyarthritis
Regardless of which finger was broken, the entire hand would have to be rebuilt because it had limited mobility for a long time.
What exercises should you do?
For complete recovery without consequences, procedures such as:
- gymnastics
- massage
- physiotherapy
The set of exercises is simple and will not take much time. They need to be performed 10 times three times a day. It’s good to first steam your fingers in a bowl of warm water and sea salt diluted in it; some exercises can be performed in water.
Regardless of the type of fracture, gymnastics should begin with the following exercises:
In addition to exercises, it is necessary to perform small painstaking work with your hands:
- sort through the cereal
- collect scattered matches
- work at the keyboard
- play musical instruments - piano, guitar, etc.
- collect construction sets, puzzles, mosaics
- do handicrafts - embroidery, applique, quilling, etc.
- Great for training manual resistance band
Read also:
What to do if ribs are broken - first aid
Rehabilitation will take about a month. Exercises and recommendations are suitable for developing fingers with any fracture.
The main thing is to do them not occasionally, but regularly.
Learn about recovery after a fracture from the following video:
Features of development after a fracture
The thumb is often broken. Such a fracture can be confused with a dislocation - only a doctor can make an accurate diagnosis.
Thumb
After removing the cast or bandage, long-term rehabilitation is required.
The thumb requires special attention. The future condition of your hand will depend on how well you work with it.
Phalanx
Exercises to develop the phalanges are simple and easy to do at home. Perform each of them 10 times, but at the same time observe your sensations. If you want to do more, feel free to do it. If pain or severe discomfort occurs, reduce the number of approaches.
Table 1. Exercises for the phalanx.
| Exercise name | How to perform |
| Lock | Lock your fingers together and knead them thoroughly. |
| Heap | Bring your fingers together so that they form a bunch. Now, without separating, spread your fingers apart. Return to starting position. |
| Fist | Clench and unclench your fingers into a fist. Try to feel every bone, every joint. The number of squeezes depends entirely on how you feel. |
| Fan | Spread your fingers as wide as you can. Don't be alarmed if it hurts a little - this is completely normal. This is a great stretch for your joints. |
| Caterpillar | Place your hands perpendicular to the table on your fingertips. Lower your hand sharply, pressing your palm to the table, gather your fingers into a fist and straighten it. Return the brush to its original position. You need to repeat it several times in a row, imitating the movements of a crawling caterpillar. |
| Lye | We connect all the fingers so that we get a spatula. Alternately make slits between your fingers. |
| Stretching | Lock your fingers together and extend your arms forward, palms facing outward, without releasing the lock. Stretch so that your fingers stretch. Now press the lock with your palms towards you. Your fingers should also stretch well. |
| Drum | Hands need to be placed on the table. Raise your fingers from the table one at a time, then together, thus drumming on the table. Make sure that your fingers lie flat, one to one. |
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A fracture of the little finger on the hand is a rare injury, occurring more often in childhood. Treatment usually does not require hospitalization or surgery.
Recovery occurs quickly, the patient retains his ability to work or is deprived of it for a period of no more than 15-20 days.
Surgery may be required only for significant damage to the phalanges of the finger, compression or splinter fractures of the little finger.
Causes of fractures
Finger fractures can result from either direct ( swipe, fall), and indirect (twisting, hyperextension) effects. You can read more about finger fractures.
There are also pathological types of injury, in which the bone, altered as a result of the disease (osteoporosis, calcium deficiency, oncological processes), is damaged by the slightest load. In this case, even normal physiological movements of the little finger can lead to a fracture.
In childhood, the most common fractures of the fingers are those caused by indirect impacts (falling on a straightened hand). Injuries suffered by adults usually result from the direct application of traumatic force (falling heavy objects onto the hand, industrial accidents).
The majority of patients with pathological fractures are elderly. This is due to age-related changes in the skeleton.
Types and symptoms of finger fractures
There are several signs that allow you to classify fractures of the little finger on the hand:
| By contact with the external environment |
|
| By offset |
|
| According to the presence of fragments |
|
| At the location of the fracture |
|
Symptoms of a fractured little finger:
When the fracture is open, bleeding is added to the symptoms described above, and bone fragments are visible in the wound.
General symptoms may occur, such as malaise, fever. A general blood test shows signs of inflammation (leukocytosis). As a rule, general symptoms occur in the absence of timely medical care and the development of inflammation in the area of injury.
Intra-articular fractures do not have such a pronounced set of symptoms. They manifest themselves as sharp pain at the time of injury, which soon subsides. The victim remains able to work for some time. After 1-2 hours, the swelling in the area of the fracture increases, and the finger loses mobility. Symptoms increase as blood accumulates in the joint capsule.
Now you know how to identify a fracture of the little finger on your hand, but if you have an injury, you should definitely consult a doctor for an accurate diagnosis and treatment!
Diagnostics
Diagnosis of little finger fractures is made based on the clinical picture. Confirmation of the diagnosis requires radiography. Pictures are taken in 3 projections:
- Direct shot (the hand rests freely on the cassette, palm down);
- Side shot (the hand is on the cassette with the edge of the palm);
- Semi-side shot (the brush is on the cassette edgewise, with the palm tilted towards the film).
In most cases, traumatologists make do with only a direct photograph of the palm. In all three projections, the hand is removed only if there is doubt about the location and nature of the fracture.
In cases where there are clinical signs of a fracture, but x-rays do not clearly confirm the diagnosis, the image is taken again. This occurs 7-10 days after the patient first seeks medical help.
First aid
First aid for fractures of the little finger includes the following set of measures:
For open fractures accompanied by bleeding, an aseptic bandage must be applied to the wound. In this case, the finger should be bandaged around the bone fragment protruding from the wound. It is better to use a sterile bandage to apply a bandage. You can treat the damaged area with alcohol solutions only at the edges of the wound so that the product does not get on open subcutaneous tissue.
Fracture treatment
Treatment of little finger fractures can be conservative, surgical, or minimally invasive.
Conservative treatment can be used for non-comminuted fractures of the little finger on the hand with or without displacement. Reduction of fragments is performed under local anesthesia. In this case, the anesthetic solution (novocaine, lidocaine) is injected not into the area of injury, but into the base of the finger.
The damaged bone is moved to the desired position by applying pressure. After this, the finger is fixed.
In order to immobilize the finger and keep the fragments in the desired position, an immobilizing bandage is applied.
Previously, only gypsum was used for this. Today, fracture fixation is often performed using bandages made of composite materials, which have less weight and ensure normal mobility of all intact fingers.
Minimally invasive osteosynthesis is performed by inserting Kirschner wires into bone fragments. In modern practice, instead of knitting needles, needles are often used to inject antibiotics into the fracture area.
Human existence is not complete without various injuries and injuries, one of which is a fracture of the little finger on the hand. This type of injury is one of the most common in everyday practice. An unfortunate fall or hit against a hard object will be enough to cause a fracture.
Causes and types
There are a sufficient number of reasons known for which a fracture of the little finger bone occurs:
- Diseases that cause bone fragility (osteoporosis, bone tuberculosis);
- Sports (boxing, various types martial arts);
- Extreme entertainment (skiing, snowboarding, skateboarding);
- Criminal fights;
- Falls on the hand;
- Work injuries (hit with a hammer, etc.);
- Hitting the little finger on hard surfaces.
A fracture of the phalanx of the little finger can be:
- Transverse - in this case the bone breaks perpendicular to the axis of the little finger;
- Oblique - the bone breaks at an angle to the axis;
- Longitudinal - the fracture line runs in a parallel direction to the axis of the little finger;
- Helical - the bone breaks and the fragments rotate parallel to the axis;
- Comminuted - not one, but several fracture lines appear, which divide the bone fragment into many fragments. They can damage the tissue, thereby forming an open fracture.
Symptoms and signs
How do you understand that this injury has occurred? A fracture of the little finger on the hand is characterized by the following symptoms:
- Sharp severe pain after traumatic exposure;
- Rapidly increasing swelling of the soft tissues around the phalanx;
- Hematoma as a result of subcutaneous hemorrhage (the finger becomes purple-blue);
- Crepitation of fragments;
- Visible deformation of the phalanx;
- Pain with axial load;
- Gaping wound with visible bone fragments;
- Neurological disorders due to nerve damage (numbness, convulsions, crawling sensation).
An experienced traumatologist will be able to diagnose this injury after a detailed examination and obtaining x-rays. Only after assessing the severity and nature of the fracture will the specialist decide what treatment tactics to use.
Important! In the first minutes after the injury, it is necessary to remove all rings from the injured hand. The swelling around the fracture site will increase very quickly, and the jewelry will compress the blood vessels and nerves. This can cause the development of tissue necrosis and impaired sensitivity of the phalanges.
Treatment
Treatment tactics for a fracture of the little finger on the hand depend on the type of fracture. For example, treatment varies depending on the displacement of bone fragments. If the little finger is fractured without displacement, a plaster cast is applied. The fifth phalanx is fixed together with the fourth, a plaster cast is applied, and the fingers are placed in a physiological position.
This type of injury heals in about 2-3 weeks. If complications arise (inflammation, infection of the hematoma), the process can take up to one month. You can use a special fixator for the little finger instead of a plaster cast. It is also called an orthosis or a phalangeal splint.
This fixation allows you to avoid displacement of fragments or improper fusion of the bone. It is especially effective for fractures of the middle phalanx. In the case where there is a displaced fracture of the little finger on the hand, a completely different treatment tactic is used.
For a closed displaced fracture, closed reduction is performed. This procedure is performed by a traumatologist together with an assistant. The fracture site is punctured with a 1% procaine solution. After this, the assistant performs light traction on the finger, and the doctor compares the fragments percutaneously. Upon completion, a fixing plaster bandage is applied.
An x-ray specialist checks whether the reduction has been performed correctly. The victim is asked to return in about a week for a repeat x-ray. This is necessary to assess the quality of fusion of fragments and prevent their re-displacement.
Operation
For an open fracture of the 5th finger with displacement, two types of surgery are performed:
- Osteosynthesis of damaged bone with knitting needles. Under local anesthesia, the doctor compares the fragments and fixes them with knitting needles passing through the bone. The wound is sutured and a plaster cast is applied. After 2-3 weeks, the needles are removed and the bandage is worn for some more time;
- Osteosynthesis with titanium plates. The tissue surrounding the damaged phalanx is dissected to allow free access to the bone. Afterwards, the fragments are compared and fixed with plates and screws. This type of surgical intervention is more modern and recommended. The plates do not restrict the movement of the phalangeal joints, which allows for early development of the fingers and the prevention of contractures.
When a fracture of the nail phalanx occurs, a hematoma forms under the nail. To prevent infection, it is recommended to undergo surgery to remove the nail. This will speed up the resorption of the hematoma and help avoid problems in the future.
A situation is possible when a tendon rupture occurs when a phalanx is fractured. In this case, it is necessary to wait until the end of the treatment period for the fracture and only after complete fusion of the bone do surgery on the tendon.
Rehabilitation and recovery
Patients are interested in how to develop the little finger on the hand after a fracture. Experienced traumatologists advise using physical therapy, massage and physiotherapy. These are the three pillars of rehabilitation on which early functional restoration rests. Thanks to a well-designed set of rehabilitation measures, it is quite possible to restore the mobility of an injured finger.
Thank You for rating this article. Published: May 29, 2017
