Hand > Finger Fracture > Treatments

   Closed Reduction, Immobilization

Treatment Introduction

Based on the nature and location of your finger fracture, your physician may inject a local anesthetic directly into your finger or hand to aid in performing a closed reduction. Once this has been done, the fracture will be reduced, or placed back in its normal position, by putting gentle pressure on the joint and moving the parts together. After a closed reduction has been performed to stabilize a finger fracture, your physician will put your finger in a protective splint to restrict mobility and speed the healing process. There are several types of splints commonly used, and your physician will suggest the best one for you. Most splints are made of a combination of plastic and rubber, though some feature aluminum strips that keep the finger in a locked position when the splint is taped securely to the finger. The splint usually is covered with padding so that the aluminum is not exposed. Depending on the nature of your injury, your physician may prescribe a splint that is attached to a short arm cast that covers your hand and wrist. The length of time that you will need to keep the splint on varies according to the severity of your injury and which finger bone is affected. This ranges from one to six weeks.

After closed reduction of a finger fracture, the length of time that you will need to keep the splint on varies according to the severity of your injury and which finger bone is affected. Follow-up will depend on how stable the dislocated joint is after reduction. If the fracture is stable and not likely to re-dislocated the doctor may ask you to return in a week or two, but if it is unstable he may want to see you again the next day. If you notice a recurrence of the deformity or a major change in range of motion or pain in the finger you should contact you doctor immediately. This may mean that the joint has re-dislocated. The longer a joint is dislocated, the more inflammation occurs, which makes it more difficult for the doctor to put the joint back into place and thereby increases your recovery time. You return to the doctors approximately 8-10 days after the procedure to have the stitches removed. A metal pin may be placed across the joint to protect the ligament for 3-5 weeks. During this time you can not get the area wet. When taking a shower you can place a large plastic bag on your arm with a rubber band at the top part of your arm. Hold your elbow over your head so that water does not role down your shoulder and into the bag. Commercially-made bags, which function in a similar way, can be purchased at a surgical supply store. Applying ice to the finger is helpful for the first two to three days. The cold causes the blood vessels to constrict (shrink). This reduces blood flow to the hand and therefore helps the body stop the internal bleeding which occurs from the torn ligament. This bleeding is seen through the skin which you call a bruise. The less bleeding there is, the less swelling there will be, which means a quicker recovery and return to activities. Keeping the hand elevated also helps because it reduces blood flow to the hand and limits swelling. Swelling in the hand causes the pressure in the tissue to increase. Your brain interprets this pressure as pain, therefore, the more swollen the hand becomes, the more painful. By elevating the hand the fluid which has collected there runs down into the forearm just like a river runs down hills. This reduces the swelling of the hand and eliminates the annoying throbbing that occurs after finger injuries.

Following closed reduction and immobilization of a finger fracture, your physician will usually suggest that you begin a program range of motion exercises as soon as possible. These can be performed with the splint on, and should be continued even if slight swelling and stiffness occurs during the first few weeks. In some cases where the finger joint remains painful, a steroid injection may be required. The splint usually remains on for 3-6 weeks, depending on your specific injury. After the splint is removed, your physician may recommend buddy taping, in which the injured finger is taped to an adjacent finger. Depending on the severity of your injury, return of full joint motion can take as long as several months. During this time swelling and stiffness may recur. In many cases, however, athletes who have suffered finger fractures may be able to return to their sports within a few weeks while the finger is still in the splint or is buddy-taped. This should only be done after consultation with your physician.

Prevention

Though finger fractures are contact injuries that often cannot be avoided, you can take steps to minimize your risk of suffering fracture. If you play contact sports such as football, hockey, or lacrosse, make sure you wear padding that protects your hands and fingers. Never use old, worn-out pads that have lost their stiffness. Maintaining hand and finger strength and coordination also can help prevent some finger injuries. Ask your physical therapist for a specific program of exercises.