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Hand Fractures

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

Any bone in the hand can be broken:

Common carpal fractures include those of the scaphoid (see Scaphoid Fractures) and the hook of hamate (see Common Hand Injuries), which are usually considered wrist fractures.

For hands to function normally, many muscles, tendons, ligaments, and bones must work together. Thus, seemingly minor fractures can seriously injure soft tissues. If these injuries are not treated appropriately, joints can become stiff, weak, or permanently misshapen, greatly disabling people.


  • A doctor's evaluation

  • X-rays

  • Occasionally computed tomography or magnetic resonance imaging

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

Sometimes doctors can diagnose a hand fracture when they examine the hand. Before the examination, a local anesthetic may be injected into the area. Otherwise, the examination might be too painful. X-rays are usually needed.

Occasionally, computed tomography (CT) or magnetic resonance imaging (MRI) is needed to identify a fracture.


  • A bandage, splint, or cast

  • Sometimes surgery

  • Hand exercises

Often, if a fracture is not treated, the hand remains misshapen and may not function normally. Therefore, doctors manipulate the hand to move the bones back into their normal position (reduction) and then immobilize the hand so that it can heal normally. A bandage, splint, or cast may be used, depending on the location and severity of the fracture.

Surgery is sometimes necessary if bones are out of position or if a joint is unstable.

Hand exercises are begun as soon as possible to prevent loss of function.

Common Hand Injuries

Common hand injuries include

  • Broken bones

  • Torn ligaments (called sprains, or ruptures)

  • Dislocated joints

When a ligament is torn, bones can move out of position, resulting in a dislocated joint.

Hand injuries cause swelling, pain, and stiffness and sometimes limit movement.

Specific Injuries

Scaphoid fractures (see Scaphoid Fractures) are a common type of wrist fracture. The area at the base of the thumb is tender and swollen.

Fractures of the hook of hamate may result from striking the ground with a stick or making a divot playing golf. The lower part of the palm at the base of the little finger is tender.

Thumb sprains (such as gamekeeper's thumb, or skier's thumb) are tears in the ligaments that attach the thumb to the hand, usually on the palm side of the thumb (see Thumb Sprains). If the ligament is severely sprained, people cannot pinch. Surgery or splinting is needed to repair a sprained ligament.

Rupture of the scapholunate ligament, a ligament in the wrist, may result from falling on an outstretched hand. Pain is felt mostly on top of the wrist. The ligament is surgically repaired.

Dislocations of fingers may occur at the base of the thumb or other fingers, at the middle joints of the fingers (usually when the finger is bent too far back), or at the joints near the fingertips (see Finger Dislocations).

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