Finger Fracture (Phalangeal)

A broken bone of the finger (phalangeal fracture) is a common injury for athletes. A single injury (trauma) is likely to fracture multiple bones on the same or different fingers.

SYMPTOMS

  • Severe pain, at the time of injury.

  • Pain, tenderness, swelling, and later bruising of the finger and then the hand.

  • Visible deformity, if the fracture is complete and the bone fragments separate enough to distort the normal shape.

  • Numbness or coldness from swelling in the finger, causing pressure on blood vessels or nerves (uncommon).

CAUSES

Direct or indirect injury (trauma) to the finger.

RISK INCREASES WITH:

  • Contact sports (football, rugby) or other sports where injury to the hand is likely (soccer, baseball, basketball).

  • Sports that require hitting (boxing, martial arts).

  • History of bone or joint disease, such as osteoporosis, or previous bone restraint.

  • Poor hand strength and flexibility.

PREVENTION

  • For contact sports, wear appropriate and properly fitted protective equipment for the hand.

  • Learn and use proper technique when hitting, punching, or landing after a fall.

  • If you had a previous finger injury or hand restraint, use tape or padding to protect the finger when playing sports where finger injury is likely.

PROGNOSIS

With proper treatment and normal alignment of the bones, healing can usually be expected in 4 to 6 weeks. Sometimes, surgery is needed.

RELATED COMPLICATIONS

  • Fracture does not heal (nonunion).

  • Bone heals in wrong position (malunion).

  • Chronic pain, stiffness, or swelling of the hand.

  • Excessive bleeding, causing pressure on nerves and blood vessels.

  • Unstable or arthritic joint, following repeated injury or delayed treatment.

  • Hindrance of normal growth in children.

  • Infection in skin broken over the fracture (open fracture) or at the incision or pin sites from surgery.

  • Shortening of injured bones.

  • Bony bumps or loss of shape of the fingers.

  • Arthritic or stiff finger joint, if the fracture reaches the joint.

TREATMENT

If the bones are properly aligned, treatment involves ice and medicine to reduce pain and inflammation. Then, the finger is restrained for 4 or more weeks, to allow for healing. If the fracture is out of alignment (displaced), involves more than one bone, or involves a joint, surgery is usually advised. Surgery often involves placing removable pins, screws, and sometimes plates, to hold the bones in proper alignment. After restraint (with or without surgery), stretching and strengthening exercises are needed. Exercises may be completed at home or with a therapist. For certain sports, wearing a splint or having the finger taped during future activity is advised.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised.

  • Do not take pain medicine for 7 days before surgery.

  • Prescription pain relievers are usually prescribed only after surgery. Use only as directed and only as much as you need.

COLD THERAPY

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

SEEK MEDICAL CARE IF:

  • Pain, tenderness, or swelling gets worse, despite treatment.

  • You experience pain, numbness, or coldness in the hand.

  • Blue, gray, or dark color appears in the fingernails.

  • Any of the following occur after surgery: fever, increased pain, swelling, redness, drainage of fluids, or bleeding in the affected area.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)