Broken Finger

What to Do About a Fractured Finger

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Finger fractures come in many shapes and sizes. Most finger fractures have simple treatments, while others may require surgical treatment. What is most important is that finger fractures are appropriately diagnosed, so the best treatment plan can be initiated. Our fingers are capable of very fine, coordinated motions, and disruption of this motion can have tremendous impacts on very normal activities such as eating, typing, or tying your shoes.

Because of the importance of our fingers, all finger fractures should be evaluated by a doctor to determine appropriate treatment.

Signs of a Finger Fracture

Most finger fractures are caused by a trauma such as a fall onto the hand. Signs of a broken finger include:

  • Pain when touching the bone
  • Swelling of the finger
  • Difficulty bending the finger
  • Deformity of the finger

Other problems of the fingers can have similar symptoms, including infections, dislocation, and tendon injuries. Therefore, it is important that you have an injury evaluated if you are unsure of the diagnosis.

Diagnosis of a Finger Fracture

If you have symptoms of a broken finger, your doctor will likely obtain an x-ray to determine if there is a fracture. Not all fractures show up well on a single x-ray, so it may be necessary to obtain multiple x-rays in different orientations if the diagnosis is unclear.

Examination of the injured finger is very helpful to guide treatment.

Examination can help to determine if there is shortening or rotation of the digit as a result of the injury. As you will see, these are important factors in guiding treatment. Examination can also be helpful to ensure there is no tendon damage or other injury that could alter the treatment recommendations.

Determining Appropriate Treatment for a Broken Finger

Treatment of finger fractures depends on three primary factors:

  • First, if the fracture involves one of the joints of the finger
  • Second, if the fracture is "stable" or "unstable"
  • Third, if there is a deformity of the finger

If the fracture involves a joint, it is important to ensure that the joint surfaces line up well. On the x-ray, your doctor will examine the joints of the fingers, and make sure there is no irregularity of the joint surface.

Second, it is important to know if the fracture is "stable" or "unstable." To determine the stability of a fracture, your doctor will look at the pattern of the break on x-ray to predict if the fracture will tend to slip out of position over time, or stay in a stable position.

Finally, your doctor will look for deformities of the finger such as shortening and rotation. Your fingers on the injured hand should line up the same way as the fingers on your uninjured hand. This means if you straighten out all your fingers on both hands, they should come to the same length.

Also, when you make a fist, your fingers should not cross, they should line up parallel to each other. Crossing of the fingers while making a fist is an indication that there may be a rotational deformity caused by the fracture.

If the joint surfaces do not line up well, if the fracture is unstable, or if there is a deformity that needs correction, surgery may be necessary to allow for optimal function after healing of the injury.

Finger Fracture Treatments

If no treatment is needed, a small splint may be applied to protect the injured finger. In some cases, the finger next to the injured finger can be used as a splint; in this scenario the two fingers are "buddy taped."

When the broken finger is out of position, the deformity may need to be corrected, or "reduced." Often this can be done under local anesthesia. In this case, an injection is given into the small nerves at the base of the finger. The injection anesthetizes the finger and allows your doctor to manipulate the fracture and correct the deformity.

If the fracture has caused joint incongruity, if it is unstable, or if the deformity cannot be corrected, then surgery may be necessary to realign and hold the broken fragments in place. Pins, plates, and screws can all be used to hold the fracture in the proper position. Finger fractures can be difficult to manage with surgery, as stiffness can be a common result after surgical intervention. Therefore, your doctor may recommend nonsurgical treatment even in some situations where the bone is not aligned perfectly. The reason is that stiffness can be a worse outcome than a subtle malalignment of the digit.

Sources:

Leggit JC, and Meko CJ. "Acute Finger Injuries: Part II. Fractures, Dislocations, and Thumb Injuries" Am Fam Physician. 2006 Mar 1;73(5):827-834.

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