The fracture of the phalanges is one of the most common injuries that is treated by the doctors in the emergency room; however, before going to the hospital it is worth trying to figure out if the finger is actually broken. A sprain or tear in the ligament is very painful, but does not require going to the emergency room; on the other hand, a fracture could cause internal bleeding or other damage that must be brought to the attention of the healthcare professional immediately.
Steps
Part 1 of 4: Recognizing the Signs of a Broken Finger
Step 1. Pay attention to pain and tenderness to touch
The first symptom of a fracture is pain and its intensity depends on the severity of the damage. After suffering a trauma to your finger, check it gently and pay attention to the level of suffering.
- It is difficult to tell immediately if it is a fracture, because pain and aching are also symptoms of dislocations and sprains.
- If you are unsure of the severity of the situation, look for other symptoms and / or see your doctor.
Step 2. Look for bruising and swelling
After the accident, you may experience sharp pain followed by swelling or a bruise. These characteristics are part of the normal response of the organism to the traumatic event; in practice, the body activates the inflammatory reaction that leads to swelling, because the fluids converge in the tissues around the lesion.
- Edema is often followed by the formation of a hematoma; the capillaries around the affected area swell or break due to increased fluid pressure.
- It may be difficult to identify a fractured finger at first, as you may still be able to move it; after a few attempts to move, the edema and bruise become more noticeable. These symptoms could also spread to the other fingers and palm.
- The finger is likely to swell and bruise within 5-10 minutes of the first sensation of pain.
- However, reduced edema in the absence of an immediate bruise could indicate a sprain and not a bone fracture.
Step 3. Pay attention if your finger is deformed or you can't move it
Fracture is the breaking or cracking of a bone in one or more places; the deformity manifests itself with abnormal bumps or with the finger bent in an unnatural way.
- If there are any signs of misalignment, the finger is likely broken.
- If there is a fracture, you usually can't move your finger because one or more bone sections are no longer connected to each other.
- Edema and hematoma make the area too stiff to move without discomfort.
Step 4. Know when to see your doctor
If you fear a fracture, go to the nearest emergency room. These lesions are complex and severity through external symptoms is not readily apparent; some need to be treated with more invasive methods to be perfectly cured. If you are unsure whether it is a fracture, it is best to be cautious and go to the doctor.
- If you complain of severe pain, swelling, bruising, decreased movement, or any deformity in your finger, go to the hospital.
- Children suffering from finger trauma should always be seen by the pediatrician. Young bones are still developing, so they are more susceptible to injuries and the complications that arise when they are not well cared for.
- If you do not undergo professional treatments, your finger and hand will remain sore and stiff with every attempt to move.
- A bone that spontaneously welds in a misaligned way prevents the correct use of the hand in the future.
Part 2 of 4: Diagnosing the Fracture in the Doctor's Office
Step 1. Undergo a visit
If you are concerned that you have sustained a fracture in your finger, see your doctor, who will evaluate the damage and determine its severity during the examination.
- The doctor looks at the range of motion in the affected area, asking you to close your fist, and notes other obvious signs, such as swelling, bruising, and bone deformities.
- He is also likely to perform gentle manipulation to examine the finger and make sure there is no reduction in blood supply or nerve involvement.
Step 2. Ask for an imaging test
If your doctor cannot come to a conclusion through a physical examination, they may recommend such a test, such as an X-ray, MRI, or computed tomography.
- Radiography is typically the first imaging test done to diagnose a fracture. The radiology technician puts his finger between an X-ray machine and a sensor, irradiating it at low intensity; the procedure lasts a few minutes, is painless and allows you to obtain images of the bone.
- A computed tomography combines several X-ray images taken from different angles. The doctor opts for this solution when the X-ray results are inconclusive or when there is a suspicion that the lesion has spread to the soft tissues.
- If you are concerned that there is a stress microfracture - an injury that occurs due to repetitive motion - you may recommend an MRI. This test produces very detailed images, which allow to distinguish microfractures from soft tissue damage.
Step 3. Find out if you need to seek surgical advice
If the fracture is major, for example open, an orthopedic surgeon is required. Some lesions are displaced and need to be stabilized with supports (such as screws and metal rods) to allow the bone fragments to fuse into the correct position.
- Any fracture that severely impedes movement or alters the alignment of the hand must be treated in the operating room to regain range of motion.
- You may be surprised how difficult it is to carry out daily activities when all your fingers do not have proper function. For professionals, such as chiropractors, surgeons, artists and mechanics, it is imperative that fine motility skills are perfect for getting their jobs done; for this reason, it is very important to take care of finger fractures.
Part 3 of 4: Treating a Broken Finger
Step 1. Apply ice, raise your hand and use a compression bandage
Manage pain and swelling with these three simple remedies; the sooner you intervene after the accident, the better. Also remember to let your finger rest.
- Apply ice packs. Wrap a bag of frozen vegetables or an ice pack in a thin towel and place it on the injured finger to manage the pain and edema. Proceed immediately, as soon as you suffer the trauma, but don't hold the compress for more than 20 minutes at a time.
- Collapse the zone. Band the finger gently but firmly using a soft elastic band; in this way, you reduce swelling and immobilize the joint. When you go to the doctor for the first visit, ask him if it is appropriate to continue to keep the finger bandaged, to reduce the risk of the edema worsening and compromising the functionality of the other fingers.
- Raise your hand. Keep your finger higher than your heart whenever possible; perhaps it is more comfortable to lie on the sofa with your legs on a cushion and your hand on the back of the sofa.
- You shouldn't use your injured finger for daily activities until your doctor allows it.
Step 2. Ask the doctor if a splint is needed
It is a device to immobilize a fractured finger and thus avoid worse damage. You can make a craft splint with a popsicle stick and a loose bandage until you can go to the doctor for professional treatment.
- The type of splint to use depends on which finger is broken. Minor fractures are usually stabilized by wrapping the injured finger with the adjacent healthy one.
- A dorsal splint prevents the finger from bending backwards; a soft support is applied to the injured finger, keeping it slightly bent towards the palm, and is secured with soft straps.
- The "U" shaped aluminum splint is a rigid support that does not allow the finger to stretch and is applied to the back of the injured finger to immobilize it.
- In severe cases, the doctor may decide to use a rigid fiberglass cast that covers the finger and the whole hand until after the wrist.
Step 3. Find out if you are going to have surgery
It may be needed to treat and heal the fracture, in cases where immobilization and time are not the right solution. Generally speaking, traumas that require an operation are more complicated than those that resolve with rigid bandages alone.
Fractures that are open, displaced, comminuted and those involving the joints must be treated in the operating room, because the bone fragments must be replaced in order to weld in the correct position
Step 4. Take some pain relievers
Your doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDs) to manage the pain associated with the injury. These active ingredients work by reducing the long-term negative effects of the inflammatory process, relieving pain and reducing pressure on the surrounding nerves and tissues, without slowing down healing.
- The usual over-the-counter anti-inflammatories used to control pain are ibuprofen (Brufen) and naproxen sodium (Aleve). You can also take acetaminophen (Tachipirina), but it is not an NSAID and has no effect on inflammation.
- If you are in severe pain, your doctor may also prescribe codeine medicines to take for a short time. The suffering is likely to be more intense in the first few days after the accident, so it is advised to reduce the concentration of drugs as the bone heals.
Step 5. Go to your family doctor or specialist for follow-up appointments, based on the instructions you have received
You will most likely be told to have a subsequent visit a few weeks after the initial treatment; perhaps new x-rays are taken after 1-2 weeks to evaluate the healing process. It's important to show up for these appointments to make sure you are on your way to recovery.
If you have any questions about the injury or other concerns, call the doctor's office
Step 6. Know the complications
Generally speaking, a fractured finger heals without any problems after medical intervention and within 4-6 weeks. The risk of subsequent complications is minimal, but it is always useful to be aware of this:
- If scar tissue forms around the fractured area, you may complain of joint stiffness. you can address the problem with physiotherapy to strengthen muscles and reduce adhesions.
- During healing, a section of the bone may rotate, resulting in deformity; in this case, surgery is required to regain the ability to grasp objects.
- The two bone abutments may not join properly and permanent instability of the fracture area may be created; this complication is called "nonunion".
- If there are skin tears near the fracture that are not cleaned thoroughly before surgery, skin infections can develop.
Part 4 of 4: Understanding the Types of Fractures
Step 1. Get to know this type of injury
The human hand is made up of 27 bones: 8 in the wrist (carpal bones), 5 in the palm (metacarpal bones) and three sets of phalanges in the fingers (14 bones in all).
- The proximal phalanges make up the longest parts of the fingers and are closest to the palm; the intermediate ones, called "middle", are the successive ones, while the distal ones are those furthest from the palm and form the "tips" of the fingers.
- Acute injuries, such as those resulting from a fall, accident and sports contact, are the most common causes of finger fractures; the tips in particular are very exposed, because they are involved in almost all the activities that are carried out during the day.
Step 2. Know what a stable fracture looks like
It is a bone break that does not involve the loss of alignment between the two abutments and is also known by the term "compound"; it is not easy to diagnose because it often causes symptoms similar to those of other injuries.
Step 3. Recognize the characteristics of a displaced fracture
Any bone fracture in which the two main abutments lose contact with each other or are no longer aligned with each other is considered displaced.
Step 4. Know the open fractures
When the broken bone moves from its location and protrudes through the skin, it is called an open fracture; as it is a serious injury to the surrounding bones and tissues, medical attention is always required.
Step 5. Learn about the comminuted fracture
This is a compound break, in which the bone has broken into three or more pieces, and is often associated with extensive tissue damage, but not always. Its diagnosis is facilitated by the presence of intense pain and the inability to move the limb.
