Metacarpal Fracture: A Broken Hand

A Metacarpal Fracture Affects the Bones That Support the Hand

metacarpal fracture
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If you have a "broken hand," you likely have sustained a metacarpal fracture -- an injury to the bone at the level of the palm of your hand. You have five metacarpal bones, one for each of your fingers. The metacarpal bones support the hand, and the end of the metacarpal bone forms the knuckle on the back of your hand.

Causes of a Metacarpal Fracture

Metacarpal fractures can occur with a variety of injuries, including:

  • falls
  • sports injuries
  • fist fights or punches
  • car accidents

Signs of a Metacarpal Fracture

Typical symptoms of a metacarpal fracture include pain and swelling of the hand. While bruising may not be seen immediately, there is usually bruising that develops within a few days of the injury.  Patients typically notice stiffness of the fingers and pain when trying to form a fist.  Symptoms will gradually improve as healing takes place.  Most metacarpal fractures fully heal in about 10 weeks, therefore it's normal to have some stiffness and swelling for that length of time.

Treatment of a Metacarpal Fracture

Treatment of a metacarpal fracture can usually be accomplished with the use of a cast. A cast is usually worn for about 6 weeks, followed by gentle motion exercises. Occasionally, if stiffness becomes a problem after cast treatment, a hand therapist will be recommended to work with you.

There are a few situations where surgery may be recommended.

If there are multiple fractures, or open fractures of the hand, surgery may be recommended. In the setting of an isolated metacarpal fracture, your doctor will assess two factors to determine if surgery is necessary:

  • Length
    Your doctor will determine if the finger is shortened because of the fracture. If it is, your doctor may recommend surgery to restore normal length of the finger.
  • Rotation
    If the finger is rotated, your doctor may recommend that this deformity gets corrected. Rotation can be assessed by making a fist. If the fingers cross over each other, there is likely a rotational deformity.

If surgery is needed, your doctor may fix the broken bone with pins, plates or screws. The type of fixation depends on the specific type of fracture.

Complications of Treatment

People who have non-surgical treatment of a metacarpal fracture may notice a bump on the back of their hand, even if the fracture is lined up perfectly.  As bone heals, excess bone often forms at the location of the fracture, therefore feeling that extra bone is common.

Complications of surgery can include infection, nerve injury, and the possible need for removing metal implants at some point down the road. 

Sources:

Henry MH "Fractures of the Proximal Phalanx and Metacarpals in the Hand: Preferred Methods of Stabilization" J. Am. Acad. Ortho. Surg., October 2008; 16: 586 - 595.

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