Hand Fracture in Children
A hand fracture is a break to one of the 27 bones in your hand and wrist. ‘Phalanges’ refer to the bones of the fingers and thumb ‘Carpals’ refer to the bones of the wrist ‘Proximal’, ‘middle’ and ‘distal’ is a naming system to specify a finger bone Fractures (or also known as a “broken bone”) are very common in children and teenagers. About half of all boys and a quarter of all girls fracture a bone sometime before adulthood. Children are flexible, so their bones may bend after a fracture. They may straighten out as they heal. This process is called remodelling. Because of remodelling, a child's fractured bone is likely to heal better and with less treatment than a similar break in an adult. Generally, fractures take six to eight weeks to unite and regain full strength at 12 weeks. For this reason it is important to avoid all sporting activities for at least six weeks after a fracture.
Your / your child’s hand may be swollen and painful when touched. The finger(s) may not be in the same position or alignment as before. It may not be possible or easy to move your hand immediately after the injury.
An x-ray may have already been performed to check the position and size of the fracture. This will help the doctor or nurse specialist decide on the best treatment for you / your child. Further x-rays are not usually required with conservative treatment (i.e. no-operation) unless there are unexpected changes or the pain continues longer than expected.
If the x-ray shows a fracture and the bone is in an acceptable position, you / your child may be given a splint or buddy straps to keep the bone in place while it heals. Splints are usually made of thermoplastic and are moulded to the shape of the hand and secured with Velcro straps, making them easy to remove if required. This can allow gentle exercises out of the splint to be started soon after an injury. The therapist or doctor will advise you / your child on safe exercises as needed.
Fractures can be safely and successfully treated by strapping the affected finger to the next finger along. The doctor or therapist will demonstrate how to put these on and for how long they need to be worn.
If the injury requires more support, a thermoplastic splint can be made, placing the hand in a safe position. Wear the splint as the therapist has advised and do not get it hot or wet or try to alter it in any way. If the splint is uncomfortable please discuss this with the therapist or contact the team by phone (contact details below).
If surgery was needed, the wound will be left with minimal or no dressing at all to help with healing. If your / your child’s stitches need to be removed, either a nurse or therapist will do this 10 -14 days after surgery. Alternatively, most stitches used are dissolvable and they should dissolve in two to three weeks. If there is a k-wire or pin, this will normally stay in place for about three to four weeks. To prevent infection, please keep the wound clean and dry until it has fully healed.
It is normal for there to be swelling (oedema) around the injured finger / hand. Any swelling can be reduced by lifting your hand above the level of your heart as much as possible when resting (elevation). The therapist may discuss other ways of helping the swelling to settle.
Please move any part of the hand that is not in the splint to prevent the joints getting stiff. Sometimes the affected finger or area will feel stiff after a fracture. You / or your child may be given hand exercises to help with this. Only do exercises if advised to do so by the therapist or doctor.
Depending on the type and location of the fracture the change in direction of the bone may get worse or the fracture may not heal.
Hand fractures normally take six to eight weeks to mend and a further four weeks to get back to full strength. You should avoid all sport for at least six weeks after a fracture or until the therapist says it is safe (whichever is the longer period).