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Finger Fractures

By Danielle Campagne, MD, Assistant Clinical Professor, Department of Emergency Medicine, University of San Francisco - Fresno

Common finger fractures include

  • Avulsion fractures

  • Crush fractures of the fingertips

Avulsion fractures occur when a tendon or ligament pulls off a small piece of bone.


Fingertip fractures (also called tuft fractures) usually result from a crush injury, such as a hammer blow. Usually, blood accumulates under the nail (called a subungual hematoma). The nail looks bluish black and may be raised up. The nail bed, located under the nail, may be torn. This injury is very painful. The fingertip is swollen and tender.

After a severe finger fracture, sensitivity in the area sometimes increases (called hyperesthesia) and remains increased long after the fracture has healed. The area may remain very tender.


  • X-rays

If people think they may have fractured a finger, they should see a doctor.

To diagnose these fractures, doctors take x-rays from several different angles.


  • A protective covering

  • For a large subungual hematoma, possibly drainage of the blood from underneath the nail

  • For severe fractures, surgery

  • Sometimes desensitization therapy

For most fingertip fractures, doctors wrap the fingertip with a protective covering (such as an aluminum and foam splint). People wear this covering for about 2 weeks.

For large subungual hematomas, doctors may make a small hole in the fingernail with a needle or a hot wire (electrocautery device) and drain the blood out (called trephination). If the nail is badly injured, it often remains misshapen.

For severe finger fractures, surgery is done to realign the many, separated pieces of broken bone.

If the nail is severely injured, the nail is usually removed. Then tears of the nail bed can be repaired. However, for most finger fractures, nail removal is not necessary.

Desensitization therapy

If the fingertip remains very sensitive after the fracture has healed, treatment to decrease sensitivity (desensitization therapy) may be needed.

People should begin desensitization exercises when their doctor recommends it, usually as soon as possible after the injury has healed. If the wound is open, people can wear a latex or vinyl glove over the hand to prevent contamination while they do the exercises. These exercises include the following:

  • Gently dragging the fingers through various materials such as dry rice, corn, sand, pellets, or beans

  • After the wound is healed, rubbing the fingertip with materials such as Velcro, cotton, or denim for several minutes throughout the day

  • Gently tapping the sensitive area for a few minutes, until if feels less tender or becomes numb

To be effective, these exercises may have to done over a long period of time.