Finger fractures are a common injury to the upper extremities in our time. The hand is the primary tool of human labor in Everyday life, and the loss of its functionality, even for a while, causes significant inconvenience. If the fracture is not taken seriously, it can end sadly.
What is a broken finger
Each finger is made up of several small tubular bones called phalanges. The thumb has two of them, and all the rest have three: nail, middle and main.
A fracture of the fingers in traumatology is considered a pathological condition in which there is a violation of the integrity of the phalanges. In this case, the bones take an abnormal position, as a result of which pain develops.
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 for an accurate diagnosis. This approach allows both grouping and separating completely different fractures from each other.
Injury classification
Fractures of the fingers are included in the general classification of traumatological 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 as a result of the impact on a healthy bone of any active damaging factor, leading to a violation of its integrity.
- Pathological or atypical fractures. The main reason for their appearance is pathophysiological processes in the bone tissue: its demineralization, a decrease in the density of the base substance and a decrease in elasticity.
According to the depth of the fracture, there are:
- Breaks. Less than half of the diameter of the bone is damaged.
- Cracks. It is characterized by a deepening of 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 going in different directions.
According to the degree of damage to soft tissues, they reveal:
- Open fracture. It is characterized by damage to the muscles, subcutaneous tissue, skin, and sometimes trauma to the vascular trunks. In an open fracture, bone debris is visible in the wound and can become a source of bacterial infection.
- Closed fracture. It implies the preservation of the integrity of soft tissues, if there is a bone defect. The main manifestation is a pathological displacement of the finger.
According to the nature of the fracture line, damage is distinguished:
- Oblique. The fracture is located at a certain angle to the surface of the damaged bone.
- Transverse. The fracture line is located conditionally perpendicular to the surface of the bone.
- Longitudinal. The fracture line runs parallel to the axis of the bone.
- Screw, or spiral. The fracture has an uneven, "twisting" character 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 by the presence of bias:
- 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 due to the traction of the muscles of the upper limb;
- angular displacement is formed due to the contraction of the flexor and extensor muscle groups in the wrong order;
- displacement along the axis occurs due to the intensive rotation of one part of the bone relative to the other.
Specific types of fractures of the phalanges
Unlike other tubular bones, the phalanx of the finger is a unique element. It is one of the smallest in the skeleton, has an intensive blood supply and has the strongest periosteum.
Classification according to the location of the fracture on the limb:
- Fractured thumb. It is one of the most common injuries of the upper limb, due to the opposition of the thumb relative to the rest.
- fracture index finger. Second most common. Most often breaks along with the middle or ring finger.
- Broken middle finger. 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 with the imposition of a plaster cast.
Classification according to the location of the fracture on the phalanx:
- Fracture of the nail (or distal) phalanx, otherwise referred to as a fracture of the fingertip. Occurs predominantly in males. This bone is very fragile, and even a minor injury can lead to sad 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 on itself.
- Fracture of the main phalanx, also called a fracture of the base of the finger. In most cases, it occurs in combination with a dislocation or subluxation of the thumb.
- Intra-articular fracture. Characterized by damage articular surfaces, which leads to a violation 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 disease prevention.
Depending on the ability of a person 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 if you carefully control your lifestyle. Rejection of 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 capacity 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 impaired. |
| Deficiency of calcium and phosphorus in the body: during demineralization, atypical bone cells are formed, 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 drugs leads to a violation of the hormonal balance in the body, resulting in fractures. | Hereditary diseases associated with mutation of genes encoding information about bone density. |
| Nutrient malabsorption contributes to the development of exhaustion and the formation of an energy deficit, which negatively affect bone tissue regeneration. | Race: Scientists have found that the faces of the Caucasian and Mongoloid races are more prone to bone fractures than others. |
Causes of a broken finger - table
| Reasons for fracture | |
| Traumatic causes | Diseases that cause increased bone fragility |
| Strong blow to limb | Malignant and benign bone tumors |
| Falls (especially if you managed to fall on the area of \u200b\u200bthe brush) | Tumor metastases to the bone from other organs: kidney cancer, brain cancer, and so on |
| Incorrectly applied splint in case of injury | Echinococcosis |
| Excessive stress during exercise | Tuberculosis of the bone |
| Violation of safety regulations during sporting events | Hematogenous osteomyelitis |
| Accident or accident at work | Secondary and tertiary syphilis |
| Compression or stretching of the limb | Osteomalacia (softening of the bone tissue) and rickets |
| Pathological muscle tension | Osteosclerosis (abnormal thickening of the 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 syndrome manifests itself after a few hours or even days. A broken finger is easily confused with a bruise or dislocation, which can delay a visit to a traumatologist. An incorrect diagnosis leads to unpleasant consequences that will have to be eliminated for a long time.
To understand at the first stages whether the finger is broken or not, it is enough to know a number of reliable signs of pathology.
Reliable symptoms of an open fracture:
- the presence of a wound: damage to the skin by bone fragments;
- bleeding from cut vessels;
- sharp soreness;
- inability to flex or extend the finger;
- displacement of fragments relative to each other;
- pronounced edema and hyperemia of the hand.
An open fracture is characterized by a wound
Reliable symptoms of a closed fracture:
- crepitus (crunching of bone fragments);
- pathological bone mobility: it can bend and unbend in places where there is no joint;
- swelling and hyperemia that do not pass for a long time;
- intense pain when touched, which disappears only after the use of painkillers.
A distinctive feature of a closed fracture is the deformation of the finger and its swelling.
Distinguishing a closed fracture from a severe bruise, guided only by clinical signs, is quite difficult. To establish an accurate diagnosis, it is recommended to contact the trauma department.
Diagnostic measures
In order to differentiate between a bruise and a fracture, the doctor conducts a thorough history taking: the place and time of the injury, the intensity and duration of the pain syndrome, the functioning of the affected finger. On examination, the traumatologist pays attention to the color of the skin, the intensity of edema and the presence of crepitus.
Reliable laboratory methods to separate a bruise from a fracture have not yet been developed. But instrumental diagnostics is widely used: X-ray of the finger in frontal and lateral projections will allow you to accurately establish the diagnosis. The image will clearly show the defect in the structure of the bone tissue. Using this method, you can determine the depth and localization of the fracture, the presence of small fragments and their displacement.
X-rays of fractured fingers - photo gallery
X-ray in two projections is required when diagnosing a fracture 
It is not always possible to see the fracture in the lateral image 
Most fractures are found on direct x-ray
Treatment
Every injury needs A complex approach. Competently provided emergency care, drug therapy and surgery reduce the number of complications to a minimum. An experienced traumatologist after making a diagnosis already has a well-planned course of treatment.
First aid for trauma
First aid is an important stage in the treatment of any pathology. The activity of regenerative processes and the correct fusion of bone fragments depend on the quality and speed of its provision.
- Anesthesia of the affected limb and reduction of edema. For this purpose, many use a heating pad with ice or a cold compress. It will also not be superfluous to take a pill of any painkiller from a home medicine cabinet: Analgin, Ketanov, Diclofenac.
- The imposition of a tight bandage above the fracture in the presence of bleeding (this position is necessary to prevent displacement).
- Immobilization of the injured finger. It is produced by fixing it to the tire, which is constructed from improvised materials, for example, a solid wooden ruler.
- Appeal to the trauma department of the hospital.
A damaged finger must be fixed in a stationary 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 the right condition, it is recommended to follow simple first aid rules.
- independently try to set broken bones inside the wound channel;
- sharply rotate, bend and unbend the injured finger - there is a possibility of displacement of fragments;
- tightly bandage the finger in the absence of bleeding: circulatory disorders can lead to gangrene;
- take medicines without a doctor's prescription: the maximum that can be used is an anesthetic 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, under x-ray control, reposition of bone fragments is performed. They are set in the correct position, which contributes to further healing. Immediately after repositioning, the finger is plastered or placed in a special fixator that will support it during the entire treatment period.
Wearing a cast is often accompanied by the appearance of bone bedsores, therefore, 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 methods finger fixation promotes better healing
For drug therapy, the following groups of drugs are used:
- Anti-inflammatory drugs - help reduce swelling and improve blood supply to tissues. For this purpose, Ibuprofen, Meloxicam, Nimesulide and Diclofenac are used.
- Painkillers. Assigned to all patients during the first weeks after the fracture. Analgin, Piroxicam and Amidopyrine reduce the intensity of pain several times.
- Immunomodulators. Help activate immune system body, helping it prevent bacterial infection in the bones. Currently used Taktivin, Timalin, Levamisole.
Diclofenac is a non-steroidal anti-inflammatory drug often used for fractures, it helps to reduce pain and relieve inflammation
Surgical treatment (operation)
In cases complicated by a fracture with displacement, it is necessary to resort to surgical intervention. Any operation is stressful for the body, so there are strict indications under which it is performed.
Indications for surgery:
- open fracture with displacement of fragments;
- closed fracture with displacement of fragments;
- intraarticular fracture;
- improper union of the old fracture;
- comminuted fractures of various localization.
The operation is carried out in several stages. First, the wound is cleaned of dirt, small bone fragments and damaged tissues are removed. Then the surgeon mobilizes the bone fragments and performs osteosynthesis: with the help of small screws, a metal structure is inserted into the distal parts of the bone, which provides a reliable comparison of the fragments and replaces the bone defect before the formation of a callus. The final stage of the operation is the suturing of the wound and X-ray control of the intervention.
In cases where the bones began to grow together incorrectly, a second reposition is performed. To do this, they are subjected to mechanical stress, forming another fracture. This operation is performed under local anesthesia.
After the formation of the correct fracture line, the wound channel is closed and a splint is applied to avoid displacement of the fragments.
ethnoscience
Folk methods for fractures are more likely auxiliary means than a complete medicine. Most of the advice is aimed at increasing the level of calcium in the body and activating recovery processes.
Folk methods should be used only after consultation with a specialist and subject to the basic therapy plan. Do not self-medicate or try to fix the fracture yourself.
The best recipes for bone tissue restoration:
- Onion decoction. Helps to activate the body's immune system. For its preparation, two or three fresh onions are used. They need to be fried in vegetable oil for twenty minutes. The resulting slurry must be boiled in hot water to a boil. Drink a decoction should be a glass a day before meals.
- Crushed chicken egg shells. It's no secret that the shell contains a large number of calcium, so necessary for the normal functioning of bone tissue. The shell of two eggs should be crushed to a state of 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 chopped walnut by adding a few drops of lemon juice. The resulting mixture is consumed twice a day after meals.
For the normal restoration of bone tissue, calcium is needed, which is so abundant in the shell of chicken eggs.
What to do with a broken finger - 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 regain strength within a few weeks. The basic rehabilitation course is selected by a traumatologist, and extended activation measures are carried out by a rehabilitologist.
Rehabilitation takes place in three main areas:
- Physiotherapy. It is recommended to use power expanders or just small rubber balls. They need to be squeezed 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. For the development of small motorboats, you can use small glass balls or ordinary buttons: shifting them from one container to another will have a beneficial effect on the function of the brush.
- Massage. You can either sign up for a massage course with a specialist, or conduct it at home. Massaging should be done regularly. It should start at the fingertips and end with middle third forearm. This promotes blood circulation in the injured limb, activating the healing process. At first, the movements should be very smooth and soft, after a few 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.
- Physiotherapy activities. Procedures begin immediately after the removal of the cast. Magnetic therapy and light therapy eliminate puffiness, relieve the intensity of the pain syndrome. 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 an irritating stimulus, the bone begins to grow with a vengeance, resulting in a huge defect. Beyond 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 the place where such movements should not be carried out. The main reason for its formation is insufficient immobilization of the finger. Treatment is performed surgically.
- Abnormal bone fusion. If reposition was not performed with a displaced fracture, the bones may not grow together correctly: 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 elimination of the problem.
- Contracture. With prolonged immobilization of the finger in the physiological position, shortening of the ligaments and tendons of the hand occurs. The function of the flexors is disturbed, and the finger is frozen in one position. For the prevention of contractures, therapeutic exercises are actively used.
- Ankylosis of the articular surfaces. With ossification of the joint, 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. It is accompanied by an intense pain syndrome and a rise in temperature to subfebrile numbers. The disease is dangerous for its generalization, which can lead to sepsis and death.
- Numbness. Often, fractures injure the nerve plexuses and blood vessels that feed the tissues. As a result, the finger may become numb. For some, this feeling is temporary, after which the sensitivity is restored. For some, finger numbness becomes a constant companion throughout life.
The doctor selects individual program recovery taking into account the gender, age and health status of the patient. With the regular implementation of these events, rehabilitation lasts one and a half to two months, and after six months, many completely forget that they once broke a finger.
Predictions and possible complications
A broken finger is an injury that does not threaten a person's life. However, for many people, their hands are a source of income: artists, architects, musicians and surgeons endure temporary disability quite hard. With a timely diagnosis, strict adherence to the terms of wearing a cast and carrying out rehabilitation, the injury heals without any tangible consequences. If there were complications during the treatment, this can lead to various complications. The most frequent of them are:
Preventive actions
To avoid injury to your fingers, you must follow the simplest safety rules. When engaging in unsafe sports, as well as when performing repairs, it is necessary to use protective gloves or special protectors that reduce the impact on the hand. If the cause of the fracture was a chronic disease associated with increased fragility of the bones, it is recommended to be treated by a doctor.
Unfortunately, it is impossible to completely minimize the risk of injury. All that a person can do in this situation is to reduce the likelihood of injury. And if a fracture occurs, contact a specialist to avoid unpleasant consequences.
Any fracture is a good reason to contact a traumatologist. When using only home remedies and methods traditional medicine serious complications can occur, leading to dysfunction of the hand. IN severe cases malunion can resort to a second 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 traumatism. In the statistics of diseases, it ranks third.
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 among the severe injuries of the hand, as they significantly reduce its functionality.
Diagnosis of a finger fracture is usually not difficult, but the treatment is different. To fully restore the shape and function of the bone, it is necessary to follow all the recommendations for the treatment of this pathology. Deviation from the requirements for treatment leads to serious complications and even disability.
Anatomy of the hand
The human hand is an extremely complex formation from the point of view of evolution. 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 movement around all three axes. Fingers are topographically related to the hand and significantly increase its functional load. Despite the fact that their bone skeleton allows them to move only in one plane, and the radius of movement does not exceed 180 degrees, thanks to the articulation with the hand, the fingers acquire the ability to make both adducting and retracting movements. This organization of the hand significantly increases the range of motion 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 site of a protrusion of a small bone tubercle on its back surface.The brush consists of three sections:
- wrist;
- metacarpus;
- brush fingers.
The wrist normally consists of 8 bones arranged in 2 rows. Proximal ( near) a row consists of four bones, forming a kind of semicircle, which is an articular fossa for articulation with the bones of the forearm. These bones include the scaphoid, lunate, trihedral, and pisiform. The second row also consists of 4 bones, which articulate with the bones of the first row from the proximal side, and from the distal side ( distant) - with metacarpal bones. Among the bones of the second row, a trapezoid, trapezoid, capitate and hamate bones are distinguished. Rarely, an additional ninth bone, called the central bone, is found on x-rays.
metacarpus
The metacarpus consists of five tubular bones, slightly curved with a bulge outward. All these bones have an elongated trihedral 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 are the 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 a 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 epiphysis bone does not form. 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 comb. 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 form of the joint eliminates the movement of the fingers in the lateral directions and allows only flexion and extension of the fingers. The distal phalanx gradually narrows and ends in a tuberosity for the attachment of muscle tendons.
On cross-section, the phalanx of the finger is an oblong bone with a canal in the center, in which the bone marrow is located. Around the canal is a thin layer of spongy substance. The spongy substance, in turn, is surrounded by a dense compact substance, which gives bone its density. The diaphysis of the bone is covered with a periosteum rich in blood vessels and nerves. The periosteum is responsible for bone growth in breadth. 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). A small strip of bone tissue located between the epiphyses and the diaphysis is called the metaphysis. It, in turn, corresponds to the growth zone responsible for the growth of the bone in length.
Ligament apparatus, muscles and their innervation
Due to the fact that there are at least 20 names of the ligaments of the hand, it would be most logical to highlight 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 single out 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, have their own collateral ligaments, which, like the first, 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 the permitted physiological limits. Thus, the collateral ligaments prevent dislocation of the metacarpophalangeal and interphalangeal joints during pathological flexion of the finger to the side.
The muscular apparatus of the hand is responsible for the movements of the fingers. It is conditionally divided into muscles of the palmar and dorsal surface. The muscles of the palmar surface, in turn, are divided into 3 groups - the muscles of the elevation of the thumb, the muscles of the elevation of the little finger and the middle group of muscles. Description of the shape of the muscles, their places of occurrence 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 placed on the function 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 muscles of the hand that are directly responsible for the movements of the fingers will be listed. The rest of the muscles of the hand will be omitted.
There are the following muscles of the elevation of the thumb:
- short abductor muscle thumb brushes;
- muscle that opposes the thumb of the hand;
- short flexor of the thumb;
- adductor thumb 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
The muscle moves the thumb towards the little finger. This muscle is innervated by the median nerve.
Flexor thumb short
The muscle produces flexion of the proximal phalanx of the thumb. Its innervation is carried out partially by the median and ulnar nerve.
Adductor thumb muscle
The function of this muscle is to move the thumb towards the proximal phalanx of the index finger ( cast) and partial flexion of the proximal phalanx of the thumb. The muscle is innervated by the ulnar nerve.
There are the following muscles of the elevation of the little finger:
- muscle that removes the little finger;
- short little finger flexor;
- muscle that opposes the little finger.
The muscle produces the movement of the little finger to the ulnar side, as well as the flexion of its proximal phalanx. Its innervation is carried out by the ulnar nerve.
Short little finger flexor
The muscle flexes the little finger and is partially involved in its adduction. Innervation is carried out by the ulnar nerve.
Muscle that opposes the little finger
The muscle moves the little finger towards the thumb. Innervation via the ulnar nerve.
Distinguish muscles middle group palms:
- worm-like muscles;
- palmar interosseous muscles.
Four small fusiform muscles carry out flexion of the proximal phalanges of all fingers except the thumb and extension of 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 bending the proximal phalanges of four fingers except the thumb and bringing them to the center line, that is, bringing them into a bundle. Innervation is carried out by the ulnar nerve.
The muscles of the rear of the hand are represented by the back interosseous muscles in the amount of four. Two extreme elbow muscles pull the middle and ring fingers towards the little finger. Two extreme muscles from the side of the radius pull the index and middle fingers towards the thumb of the hand. 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 fractures is trauma, and the mechanism of damage is accordingly 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 the fracture occurs not in 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 bone of the phalanges are theoretically possible, but in practice they are an extreme accident. 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 with sharp bone fragments. Although the phalanges are tubular bones capable of forming sharp ends when fractured, more often this does not occur and the fracture remains closed. Presumably this is due to the small size of the phalanges and insufficient leverage of force in order to damage the sufficiently strong skin of the fingers from the inside. However, if there is still an open fracture of the finger, then the risk of such a complication 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 overlapping of the edges of bone fragments.
According to the number of bone fragments, the following types of fractures are distinguished:
- splinter-free;
- single-splintered;
- two-splintered;
- multisplintered ( fragmented).
- longitudinal;
- transverse;
- oblique;
- S-shaped;
- screw;
- T-shaped, etc.
Finger fracture symptoms
Symptoms of a finger fracture are generally identical to fractures of other localizations. They are conditionally divided into probable signs of a fracture and reliable. Possible signs of a fracture include:
- local edema at the fracture site;
- soreness over the fracture site;
- sparing position of the finger;
- redness at the fracture site;
- warmer skin over the fracture site compared to the surrounding skin;
- inability to move a finger;
- soreness when trying to put pressure on its top.
- palpatory discontinuity of the bone ( crack);
- visual change in the shape of the bone;
- pathological bone mobility where it should not be;
- bone crepitus ( crunch) when trying to displace bone fragments;
- visual shortening of the broken finger in relation to the healthy finger of the other hand.
Finger Fracture Diagnosis
Diagnosis of a finger fracture is made according to the above clinical signs. To confirm the diagnosis, an x-ray of the hand or a separate finger is taken in the direct 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 is extremely useful when choosing a method of treating a patient. Theoretically, it is possible to use more modern methods to diagnose a finger fracture, such as computed tomography, however, in practice this is never performed for two reasons. Firstly, computed tomography is a rather expensive study, and secondly, a simple x-ray in two projections, as a rule, is enough to understand what kind of fracture the patient came with and what approach to treatment is most acceptable.
It is important to remember that finger radiography must be repeated after removal of the cast in order to check the quality of bone union and the correct position of the intraosseous fixation devices.
First aid for suspected finger fracture
First aid is the first step in treating a patient with any pathology. From the correctness of measures aimed at alleviating the patient's condition, depends on how successful the entire treatment will be as a whole. A broken finger is no exception, so first aid will be focused on several tasks - pain relief, immobilization of the upper limb and combating complications. Do I need to call an ambulance?
Many 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 are wrong. Call an ambulance is necessary for the following reasons.The pain syndrome during 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 bloodstream, which support inflammation and ultimately increase pain, completing a vicious circle.
In order to reduce pain in the arsenal of ambulance medicines, there are various painkillers, from the weakest in their effect to the strongest that exist 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 finger fracture 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.
Rarely, but it happens that a digital artery or one of the digital veins is injured by fragments of broken phalanges. In this case, rather massive bleeding develops, which is not always possible to stop by simply pressing on the bleeding vessel, and even more so if there are several damaged vessels. Ambulance workers are trained to stop bleeding by applying a tourniquet where the main blood vessels that feed 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 kerchief bandage or an impromptu 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 to the body with the help of special bandages such as Velpo and Deso. This manipulation further immobilizes the hand and secures the broken finger.
Is it necessary to give pain medication?
As mentioned 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, which must be interrupted to reduce the progression of the symptoms of inflammation. To this end, it is necessary that the victim take either an analgesic or anti-inflammatory drug as soon as possible after the injury.At home, the most common anti-inflammatory and pain medications are:
- ibufen;
- meloxicam;
- nimesil, etc.
Do I need to do immobilization?
In this case, immobilization means temporary immobilization of the fracture site in order to prevent increased pain and the development of complications. Such immobilization is called transport immobilization, since it is during transportation to the hospital or injury point that the risk of secondary damage to broken phalanges is high.As mentioned above, there is no specific position in which to fix a broken finger. It is important to fix it in the position in which the patient feels the least pain with the muscles of the hand relaxed. To reduce the risk of accidental injury to the finger, the entire arm should be immobilized and, if possible, pressed against the body.
As a rule, with a simple closed fracture, immobilization is not applied to the finger itself. However, with complex multi-comminuted fractures, sometimes it becomes necessary to immobilize it. Immobilization can be done 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 a broken finger, protruding 2–4 cm beyond its top. The second end lies on the palmar surface of the hand and forearm and is fixed. Then, with the help of a bandage, they carefully wrap the arm together with the splint, starting from the elbow edge and slowly advancing until the hand and finger are hidden under the tours of the bandage.
The second method is simpler, but less efficient. It consists in tying a broken finger to an adjacent or several adjacent fingers. This method of fixation is most suitable for closed finger fractures without displacement of bone fragments.
Should I apply cold?
Cold is the first pain reliever and anti-inflammatory used by humans. The mechanism of its action is to reduce the temperature of the tissues and the 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 drops below 4 degrees, its activity slows down until it stops completely.The mechanism of action of cold differs from the mechanism of the therapeutic action of painkillers and anti-inflammatory drugs. Therefore, cold can be safely combined with medicines. 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 part of the body on which it is applied much better. As a result, the area of contact between the skin and ice increases and faster and better anesthesia of the fracture site occurs.
It is important to remember that extremely low temperatures exposed to living tissues 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 broken finger
Treatment of a finger fracture is carried out according to various methods, depending on its complexity and associated complications. The traditional treatments for a finger fracture are:
- simultaneous closed reposition;
- methods of skeletal traction;
- open reduction.
Simultaneous closed reduction
Single-stage closed reposition of bone fragments is carried out with simple closed fractures with displacement. The classic displacement of fragments with such a fracture occurs in the palmar side, that is, an angle open to the back of the hand. Closed reposition is carried out in several stages. First, a test is made to determine whether the patient has 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 injected gradually into the tissues surrounding the fracture. When anesthesia is achieved, traction is performed ( thrust) of the finger along its axis. Then slowly bend all the joints of the finger until an angle of approximately 120 degrees is reached. After that, 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. In the future, only the damaged finger is fixed in a partially bent position, while the rest remain free. Immobilization of healthy fingers is considered a mistake, as it leads to the development of ankylosis ( shortening and hardening of the ligamentous apparatus, preventing the movement of the limb in full). Upon completion of the manipulation, the patient is recommended to keep the limb in an elevated position for 2-3 days to reduce swelling, and also to take painkillers in medium dosages indicated in the attached instructions.
Skeletal Traction Methods
This method of treatment is used for multi-comminuted closed fractures or when, after one-stage reposition, it is not possible to fix the bone in the correct position. As in the previous case, a test for the tolerance of the anesthetic substance is carried out. When it turns out to be negative ( allergic reaction does not develop), the same splint is applied to the forearm and hand as in the previous treatment method, but with one modification. On its palmar surface, opposite the broken finger, a strong wire is fixed, extending a few 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 that the finger is pulled with a thread, pin or staples passed through the soft tissues of the finger or nail phalanx. For a stronger fixation of the structure, the nail is covered with several layers of polymer varnishes, which are used in cosmetology for nail extension. After the manipulation, the patient is prescribed a prophylactic course of antibacterial, anti-inflammatory and analgesic treatment.
Open reduction
This method of treatment is the last one resorted to by doctors for fractured fingers. The fact is that open reposition, in fact, is a surgical intervention on an open bone and it is accompanied by all the complications characteristic of operations in principle - wound suppuration, suture failure, osteomyelitis, etc. However, with certain indications this method is the only possible treatment for finger fractures. As a rule, these indications include an open simple or multi-comminuted fracture with displacement, an improperly healed fracture requiring bone destruction and repositioning, and purulent complications of previous treatments. 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 gypsum, 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 processing, since in itself it is a foreign body and a potential source of an inflammatory reaction.
Do I need to apply plaster?
Proper treatment of finger fractures always involves the application of a cast. A broken finger refers to fractures of high complexity, so the attitude to its treatment should be as serious as possible. In order to achieve best results it is necessary to carry out reliable immobilization of the fracture site. The most common material for applying an immobilizing dressing is a bandage soaked in a concentrated gypsum solution. When dried, the gypsum takes the form of a limb and for a long time retains the necessary rigidity of the structure to ensure the required level of immobilization. In addition to gypsum, there are other substances used to fix the upper limb in case of finger fractures. We are talking about special polymers that are applied like a plaster cast, but without the use of 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 the ingress of liquid, as when using gypsum, which collapses in this case. It goes without saying that not every hospital has modern polymeric materials for immobilization. In addition, they are most often not covered by the health insurance policy and must be paid from the patient's budget.
As mentioned above, when a finger is fractured, a cast is applied starting from the near part of the forearm, passes to the hand and ends with a separate fixation of only the broken finger. At the same time, it is important to initially take care of the correct position of the brush, since when the gypsum hardens, it will no longer be possible to change it. Correct position hand implies extension at the wrist joint by approximately 30 degrees and flexion of the phalanges of the fingers ( if skeletal traction methods were not used) to a position in which the tops of the fingers would lightly touch the palm. This position of the hand ensures the prevention of re-displacement of bone fragments, as well as the prevention of contractures. If contractures still develop, this position of the hand allows you to save its grasping function.
How long is the plaster needed?
With simple closed finger fractures without displacement, the terms of plaster immobilization are on average 2-3 weeks. Full recovery of working capacity occurs in 3-4 weeks.For fractures of moderate complexity, namely closed simple and multi-comminuted fractures with displacement, as well as fractures requiring skeletal traction, gypsum is applied on average for 3-4 weeks with recovery for 6-8 weeks.
In complex open multi-comminuted fractures using osteosynthesis methods ( restoring the integrity of the bone by implanting pins, screws, etc.) the terms of wearing a cast sometimes reach 6 weeks, and the full recovery of the finger's ability to work occurs at 8-10 weeks.
Complications of self-treatment of fractured fingers
The treatment of finger fractures should be approached responsibly, 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:
- the formation of a large bone callus;
- the formation of a false joint;
- contracture formation;
- the formation of ankylosis;
- improper fusion of the bone;
- osteomyelitis, etc.
Callus formation is a normal physiological step in the healing of any fracture. However, if the bone fragments are misplaced, a giant 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 incorrectly aligned, the axis of the bone also changes. Together with the change in the axis, it decreases and 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, as a result of which the callus grows. In addition to the aesthetic defect, the callus often limits the movement of the finger, reducing its participation in the activities of the entire hand.
Formation of a false joint
A false joint is a place of free flexion of a limb where normally there should be no flexion. False joints are formed when closed fractures of the phalanges are not sufficiently immobilized. As a result, at the fracture site, the movement of bone fragments continues and their gradual erasure against each other. Over time, the sharp ends become blunt and even rounded, and the bone canal overgrows. At some point, one solid bone becomes two shorter bones, between which there is a small gap. It is thanks to this clearance that the movement between the fragments of the once intact bone is preserved.
Unfortunately, the false joint is functionally untenable, painful and is a constant focus of inflammation in the body. It is unfortunate that the treatment of this complication is only surgical and consists in the destruction of the edges of the false joint and the re-combination of bone fragments. The success of such an operation is always doubtful due to the fact that after it a large callus is formed, the bone, and accordingly the limb, is shortened and the risks of developing secondary iatrogenic ( caused by medical manipulation) 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 the event of a finger fracture with an incorrect position of the hand during immobilization of the upper limb, uneven tension of its tendons occurs. Some tendons tighten, others relax and shorten over time. After the plaster is removed, those tendons that have been stretched do not interfere with movements in the joint, and those that have shortened do not allow arbitrary movements in the opposite direction to the ligament. The treatment of contractures is long and painful, as it is associated with daily stretching of the shortened tendons.
Ankylosis formation
Ankylosis is the fusion of the articular surfaces of a certain articulation and the formation of a solid bone at the site of the joint. This complication can develop when the fracture affects the joint and is not treated appropriately. As a rule, most patients become disabled for life, as effective treatment this complication does not exist today.
Irregular bone fusion
In open fractures and closed fractures with displacement, the obligatory stage of treatment is the reposition of bone fragments. Reposition refers to the return of bone fragments to their original physiological position. In the absence of fragment reposition, poor quality reposition or weak immobilization, one of the bone fragments is displaced ( more often distal) away from the correct axis. If the bone is kept in this position for several weeks, the fracture heals and the distal fragment remains permanently in the wrong position. In addition, a large callus is formed, which prevents the normal movement of the finger.
Osteomyelitis
Osteomyelitis is the development of inflammation of the bone marrow. There are 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 trauma or surgery. With an open fracture of the finger, the development of secondary osteomyelitis is most likely due to the absence or insufficiency of the primary wound treatment. This disease is very painful and often acquires a chronic course with frequent phases of exacerbation. As a rule, an exacerbation occurs after the bone has grown together. 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 relieved with large doses of opiates ( morphine, omnopon), and patients sometimes even beg to have a 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 access is closed. However, in some cases, when the bone overgrows, 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 there are complications associated with the multi-stage nature and technical difficulties in performing this surgical intervention.
What is the recovery period after the operation?
The type of surgical treatment of a finger fracture largely affects the duration of the recovery period. In addition, purulent complications have a great influence, which can cause multiple repeated operations aimed at cleansing the purulent focus. An important factor affecting the rate of recovery after surgery is the patient's age and comorbidities. Thus, in children, the rates of bone fusion and tissue regeneration are the highest. In people under 40 years of age, the pace of recovery is kept at a sufficient high level and then slowly decrease every year. Among the diseases that cause a slowdown in the regeneration of bone and connective tissue are diabetes mellitus, hypothyroidism, parathyroid tumor, etc. Osteosynthesis with the help of spokes and screws can be either one-stage or two-stage. With one-stage osteosynthesis, fixation devices remain in the patient's bones for life, and with two-stage osteosynthesis, they are removed 3–4 weeks after the injury by repeated minimally invasive surgical access. Accordingly, with one-stage osteosynthesis, the recovery period lasts an average of 4-6 weeks, and with a two-stage osteosynthesis it is extended 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 course of fracture healing, the recovery time is on average 6-8 weeks. With constant moderate inflammation, the recovery time is delayed by 1 to 2 weeks. With a pronounced inflammatory process 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 eventually be 10 to 14 weeks.
In the event of a rupture of the ligaments or tendons of the muscles and their suturing during the operation, in the recovery period, as a rule, their significant shortening occurs. As a result, after the fusion of the fracture, the patient is not able to fully use the fingers, since they are limited in mobility. Tendon development can also take up to two weeks, which must be added to the time of removal of the plaster immobilization. On average, the period of complete recovery is 6-8 weeks, depending on the severity of the fracture itself.
What physiotherapy is indicated after a fracture?
Physiotherapy greatly contributes to the acceleration of the treatment of any fracture. The physiotherapeutic effect is based on the effect of natural factors on the bone and the effect on the rate of metabolic processes in it. The positive effect of physiotherapy is manifested in analgesic, anti-inflammatory, anti-edematous, myostimulating, trophic and other positive actions. Physiotherapy for broken fingers
| 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. Improvement of blood supply and tissue oxygenation. Moderate anti-inflammatory and analgesic effect. Relaxation of the smooth muscles of the blood vessels. Acceleration of the formation of callus. | Starting from the 3rd day after the reposition of fragments. 10 - 15 procedures. Daily. The duration of the procedure is 10 - 15 minutes. With a weak intensity of radiation, an anti-inflammatory effect is exerted. With radiation of medium strength, metabolic processes are mainly stimulated. |
| Physiotherapy | It is made only on healthy fingers in order to prevent contractures. Improving microcirculation and blood supply to tissues. Maintaining an optimal level of cellular metabolism. | From the 3rd day after the reposition of fragments. Daily. 10 - 20 procedures. The duration of the procedure is 5 - 10 minutes. |
| Warm baths with baking soda and salt | Analgesic effect by reducing the sensitivity of pain receptors. Pronounced anti-inflammatory action aimed at joints and bones. Relaxation of vascular smooth muscle. Improvement of blood supply to tissues. Moderate fibrinolytic effect, aimed at softening the ligaments and treating ankylosis. | It is used from the day the plaster is removed. 12 - 15 procedures. Daily or every other day. The duration of the procedure is 10 - 15 minutes. The water temperature is within 35 - 39 degrees. |
| exercise therapy | Development of contractures of the elbow, wrist and hand joints. Reorganization of the connective tissue of ligaments and tendons. Stretching of the joint capsule. | It is used from the day the plaster is removed. 15 - 20 procedures. Daily or every other day. The duration of the procedure is 15 - 20 minutes. |
| Applications of ozocerite | Superficial and deep tissue heating. Vasodilating action. Improving the metabolism of bone and muscle tissue. Reflex effect on the nerve centers. Increasing the body's resistance to aggressive factors. | 3 - 5 days after the removal of the plaster. 8 - 10 procedures. Daily. The duration of the procedure is 10 - 15 minutes. |
| Mechanotherapy | Recovery of fine 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. |
Broken fingers are a fairly common occurrence. These injuries account for about 10% of the total number of fractures. A fracture of the fingers requires a long rehabilitation after the fusion of the bone - the hands and feet must be developed so that they retain their beauty and mobility. Learn how to develop a finger after a fracture.
Development of fingers on the hand after a fracture
Treatment of a finger fracture is associated with limiting its mobility. A bandage or plaster is worn for no more than a month - during this time the bones should grow together, 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, in no case should you immediately load the arm, a long and gradual rehabilitation is necessary.
The further condition of your hand will depend on the seriousness with which you approach the restoration of the motor function of the fingers.
By training, developing a hand, you can avoid such phenomena as:
- mobility impairment
- appearance of bone marrow
- post-traumatic arthritis
Regardless of which finger was broken, the whole hand will have to be worked out, because for a long time it was limited in mobility.
What exercises to do
For a complete recovery without consequences, procedures such as:
- gymnastics
- massage
- physiotherapy
The set of exercises is simple and does not take much time. You need to perform them 10 times three times a day. It is good to pre-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 out the groats
- collect scattered matches
- work at the keyboard
- play musical instruments - piano, guitar, etc.
- collect constructor, puzzles, mosaic
- do needlework - embroidery, appliqué, quilling, etc.
- great for training hand expander
Read also:
What to do if the ribs are broken - first aid
The recovery 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 proposed video:
Features of development after a fracture
The thumb is often fractured. Such a fracture can be confused with a dislocation - only a doctor can make an accurate diagnosis.
Thumb
After removing the plaster or bandage, a long rehabilitation is required.
The thumb needs more attention. How well you work with it will depend on the further condition of your hand.
Phalanx
Exercises for developing phalanxes are simple, they are easy to perform at home. Do each of them 10 times, but at the same time observe your feelings. If you want to do more, feel free to do it. If pain or severe discomfort appears, reduce the number of approaches.
Table 1. Exercises for the phalanx.
| Name of the exercise | How to perform |
| Lock | Put your fingers together in a lock and knead them well. |
| handful | Connect your fingers so that they gather in a pile. Now without separating, spread your fingers apart. Return to initial 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 worry if it hurts a little - it's completely normal. This is a great stretch for the 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. Return the brush to its original position. You need to repeat several times in a row, imitating the movements of a crawling caterpillar. |
| lye | We connect all the fingers so that we get a shoulder blade. Alternately we make cracks between the fingers. |
| Stretching | Interlock your fingers into the lock and stretch your arms forward with your palms outward, without separating the lock. Stretch so that your fingers stretch. Now press the lock with your palms towards you. Fingers should also stretch well. |
| Drum | Hands should be placed on the table. Raise your fingers from the table alternately, then together, thus drumming on the table. Make sure that the fingers lie exactly, one to one. |
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Fracture of the little finger on the hand is a rare injury that occurs more often in childhood. Treatment usually does not require hospitalization or surgery.
Recovery occurs quickly, the patient retains his ability to work or loses it for a period of no more than 15-20 days.
The operation may be required only in case of significant damage to the phalanges of the finger, compression or comminuted fractures of the little finger.
Causes of fractures
Finger fractures can result from both direct ( swipe, fall), and indirect (twisting, overextension) impact. You can read more about finger fractures.
There are also pathological types of trauma. 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 finger fractures are caused by an indirect impact (falling on a straightened hand). Injuries sustained by adults are usually the result of the direct application of traumatic force (falling heavy objects on the hand, accidents at work).
The majority of patients with pathological fractures are elderly people. 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 |
|
| Offset |
|
| By the presence of fragments |
|
| At the site of the fracture |
|
Symptoms of a fracture of the little finger on the hand:
With the open nature of the fracture, bleeding is added to the above described signs, bone fragments in the wound are visible.
General symptoms may occur, such as malaise, fever. In the general blood test, signs of inflammation (leukocytosis) are noted. 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 are manifested by sharp pain at the time of injury, which soon subsides. The victim remains functional for some time. After 1-2 hours, the swelling in the area of the fracture increases, the finger loses its mobility. The increase in symptoms occurs as blood accumulates in the joint bag.
Now you know how to determine a fracture of the little finger on the hand, but in case of injury, you should definitely consult a doctor for accurate diagnosis and treatment!
Diagnostics
Diagnosis of fractures of the little finger is made on the basis of the clinical picture. Confirmation of the diagnosis requires an x-ray. Pictures are taken in 3 projections:
- Direct shot (the brush rests freely on the cassette with the palm down);
- Side shot (the hand is on the cassette with the edge of the palm);
- Semi-lateral shot (the brush is on the cassette with an edge, with the palm tilted towards the film).
In most cases, traumatologists manage only with a direct picture 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 the x-ray does not allow unambiguous confirmation of the diagnosis, the picture is taken again. This occurs 7-10 days after the patient's first request for medical help.
First aid
First aid for fractures of the little finger includes the following set of measures:
In case of open fractures accompanied by bleeding, an aseptic bandage should be applied to the wound. In this case, the finger should be bandaged around the bone fragment protruding from the wound. To apply a bandage, it is better to use a sterile bandage. It is possible to treat the injury site with alcohol solutions only along the edges of the wound so that the agent does not fall on open subcutaneous tissues.
Fracture treatment
Treatment of fractures of the little finger is conservative, operative and minimally invasive.
Conservative treatment can be used for comminuted fractures of the little finger on the hand with or without displacement. Reposition 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 pressure. After that, 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, the fixation of fractures is often performed using bandages made of composite materials, which are lighter and provide normal mobility of all intact fingers.
Minimally invasive osteosynthesis is performed by introducing Kirschner wires into bone fragments. In modern practice, needles are often used instead of knitting needles, which allow antibiotics to be injected into the fracture area.
The existence of a person 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. To get a fracture, an unsuccessful fall or hit against a solid object will be enough.
Causes and types
A sufficient number of reasons are known, due to which a fracture of the little finger bone occurs:
- Diseases that provoke bone fragility (osteoporosis, tuberculosis of bone tissue);
- Sports activities (boxing, different kinds martial arts);
- Extreme entertainment (skiing, snowboarding, skateboarding);
- Crime fights;
- Falls on the hand;
- Industrial injuries (hitting with a hammer, etc.);
- Hitting with 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 turn parallel to the axis;
- Comminuted - not one, but several fracture lines appear, which divide the bone fragment into many fragments. They can damage tissue, thereby forming an open fracture.
Symptoms and signs
How to 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 impact;
- Rapidly increasing swelling of the soft tissues around the phalanx;
- Hematoma as a result of subcutaneous hemorrhage (the finger becomes purple-blue);
- Crepitus of fragments;
- Visible deformation of the phalanx;
- Pain with axial load;
- A gaping wound with visible bone fragments;
- Neurological disorders due to nerve damage (numbness, convulsions, a feeling of "crawling").
An experienced traumatologist will be able to diagnose this injury after a detailed examination and obtaining x-rays. Only by assessing the severity and nature of the fracture, the specialist will decide which treatment tactics to apply.
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 pinch the vessels and nerves. This can cause the development of tissue necrosis and impaired sensitivity of the phalanges.
Treatment
The treatment of a fracture of the little finger on the hand depends on the type of fracture. For example, treatment differs depending on the displacement of bone fragments. In case of a fracture of the little finger without displacement, a plaster cast is applied. The fifth phalanx is fixed together with the fourth, plaster is applied, and the fingers are set in a physiological position.
This type of injury grows together in about 2-3 weeks. If complications (inflammation, infection of the hematoma) join, the process can take up to one month. You can use a special retainer for the little finger instead of a plaster cast. It is also called an orthosis or a phalanx splint.
Such a fixator avoids the displacement of fragments or improper fusion of the bone. It is especially effective in fractures of the middle phalanx. In the case when there was a fracture of the little finger on the hand with a displacement, a completely different treatment tactic is used.
In a closed fracture with displacement, a closed reduction is performed. This procedure is performed by a traumatologist together with an assistant. The fracture site is chipped with 1% procaine solution. After that, the assistant performs light traction of the finger, and the doctor compares the fragments percutaneously. At the end, a fixing plaster bandage is applied.
Radiologically, the specialist checks whether the reposition is correctly performed. The victim is asked to come back in about a week for a second x-ray. This is necessary to assess the quality of the fusion of fragments and prevent their re-displacement.
Operation
With an open fracture of the 5th finger with displacement, two types of surgery are performed:
- Osteosynthesis of the damaged bone with pins. Under the influence of local anesthesia, the doctor compares the fragments and fixes them with needles passing through the bone. The wound is sutured and a plaster bandage is applied. After 2-3 weeks, the needles are removed, and the bandage is worn for some more time;
- Osteosynthesis with titanium plates. The tissues surrounding the damaged phalanx are dissected for free access to the bone. After fragmentation, they are compared and fixed with plates and screws. This type of surgery is more modern and recommended. The plates do not restrict the movement of the joints of the phalanges, which provides the possibility of early development of the fingers and the prevention of contractures.
When there is a fracture of the nail phalanx, a hematoma forms under the nail. To prevent its infection, it is recommended to perform an operation 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, with a fracture of the phalanx, a tendon rupture occurs. In this case, it is necessary to wait for the end of the period of fracture treatment and only after complete fusion of the bone to perform 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 to apply physiotherapy exercises, massage and physiotherapy. These are the three pillars of rehabilitation on which the early recovery of functions rests. Thanks to a well-designed complex of rehabilitation measures, it is quite possible to restore the mobility of the injured finger.
Thank you for rating this article. Published: 29 May 2017
