One of the concerns of people who have had their hands in a cast or splint for a long period, or have had their hands kept in a fixed position for some reason, is the reduced range of motion in their fingers and joints, as well as the feeling of stiffness and rigidity when moving the hand.
Sometimes when falling, the fingers of the hand get injured or fractured. These fractures cause disruptions in daily activities, especially if a person has a job that requires continuous use of their fingers. For a period, they may not be able to easily perform their tasks. This issue causes distress and concern for the patient, and they often seek a quick solution to treat the fracture and injury in their fingers.
The hand has five fingers, and each finger has three movable joints. The part with the nail is the small and distal joint. The next joint is the middle joint, and the last one, which is connected to the palm, is called the proximal joint. Each palm consists of five metacarpals, with each finger having a metacarpal bone.
The thumb is different from the other fingers in both the number of joints and the metacarpal bone. It consists of two joints (the distal and proximal joints), and the metacarpal bone connects to the proximal joint. The thumb metacarpal is a movable bone, and it differs from the other metacarpals. When grasping an object with the hand, the thumb is positioned opposite the other fingers and helps us hold the object easily.
The hand, like other body parts, has various sections that can be injured due to trauma. First, let's get familiar with the types of finger fractures:
This fracture occurs in two joints and in the metacarpal. It is important to note that a metacarpal fracture in the thumb is more significant than the metacarpals in other fingers. Thumb fractures are caused by direct impacts, such as falling, or indirect impacts, such as twisting the thumb during sports like wrestling, skiing, etc. The main symptom is intense pain in the fractured area, which increases with direct pressure on the fracture site. Other signs of this fracture include swelling and an inability to move the thumb. Other symptoms may include tingling, numbness, and a change in the appearance of the finger. The diagnosis is made by an orthopedic specialist.
Intra-articular Fracture: A fracture in the proximal joint, typically occurring as an oblique line inside the joint. This is called a Bennet fracture.
Extra-articular Fracture: This fracture occurs outside the joint, with the fracture line being either transverse or oblique, without extending into the joint. This can lead to arthritis.
These fractures occur in the three joints: the distal joint, the middle joint, and the proximal joint, as well as the metacarpal bone. These fractures can occur in one or several joints, in one or more fingers, and may also involve the palm. Finger fractures occur due to direct impacts, indirect impacts, or conditions like osteoporosis.
Single or Multiple Joint Fractures
Intra-articular Fracture
Extra-articular Fracture
Non-displaced Fracture: This fracture does not cause any bone displacement, and the broken pieces remain in place. (For extra-articular fractures, when this type occurs, a short spica cast is applied to the thumb to keep the finger in a proper position.)
Displaced Fracture: This fracture causes bone displacement, and the broken pieces move apart. After realigning the fracture, the doctor may place the hand in a spica cast for about 4 weeks. Once the bones heal, an X-ray is taken to ensure the fracture is fixed and there is no displacement.
Open and Severe Fracture: This type of fracture involves bleeding, bone protruding through the skin, and severe injury. The risk of amputation is high, and there is a significant risk of infection, requiring immediate treatment.
The treatment for finger fractures depends on the type, location, and severity of the fracture.
Non-Surgical Treatment:
If the fracture is non-displaced, the broken finger is immobilized by tying it to an adjacent finger with tape (this immobilization must allow the joints to move easily).
If the fracture involves bone displacement, the finger is kept in place with a splint or cast until the bones heal (usually in about 3 weeks).
Surgical Treatment:
If the fracture occurs in a critical area, or the injury is severe, an open fracture, or if the fracture affects blood vessels and nerves, surgery may be necessary.
After undergoing surgery or treatments such as taping, splinting, or casting, it is essential to perform exercises and physiotherapy to increase the range of motion in the fingers, reduce pain, and help the patient return to their activities more quickly. The physiotherapist will guide you to achieve the best results in the shortest time.
Laser Therapy: Low-level laser therapy helps reduce pain and swelling in the fractured area.
Hot and Cold Therapy: Cold therapy reduces blood flow to the injured area, decreasing pain and swelling, while heat therapy increases blood flow and aids in healing.
Ultrasound: Ultrasound helps reduce inflammation and swelling, and it promotes nerve healing by sending waves to repair tissue.
Shockwave Therapy: This is used to repair wounds and fractures and to help with tissue healing and bone union.
Electrical Stimulation: A non-invasive and effective method to promote bone healing and the union of broken parts.
Massage Therapy (Chiropractic): Massage helps reduce pain, swelling, and stiffness in the joints and accelerates healing in the fractured area.
Exercises aimed at strengthening the fingers include:
Beginner Exercises to improve the range of motion:
Playing board games like chess and checkers, which involve moving pieces.
Stacking coins: Take a handful of coins and stack them to improve finger motion and strength.
Virtual piano games: Use piano apps on your phone or tablet to exercise finger movements.
Strengthening with a Clip: Use a clip and press it with your fingers (thumb and index), then move to the middle finger, and continue to the pinky.
Typing: Type with your fingers one by one or in groups, to enhance finger movement.
Wrist Stretch and Flexion: Rest your forearm on the edge of a table and move your wrist up and down.
Arm Stretch: Hold your fingers together and pull the affected arm upwards to stretch your arm muscles.
Thumb Stretch: Open your hand and move the thumb in and out, repeating the movement.
Finger Stretching: Place your fingers on a flat surface like a table and hold the position for 30-60 seconds.
Hold a therapy ball and press it with your fingers and thumb. Focus on applying pressure with the fingers.
Press the ball with your fingers and thumb from above and below.
Roll the ball with your thumb in circular motions.
Use warm water massage or essential oils for relief.
Avoid excessive pressure on the hand.
Regularly check the status of the fingers with your doctor.
Continue physiotherapy exercises as prescribed.
Typically, healing for finger fractures takes about 4 to 8 weeks, depending on the degree of injury, fracture type, and physiotherapy consistency. Full recovery can take less or more time depending on the situation. To ensure proper bone union and avoid complications like deformities, it’s important to follow the prescribed physiotherapy regimen and consult with your doctor and physiotherapist throughout the recovery process.
