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Our fingers are extremely delicate and get knocked, bruised and battered on an almost-daily basis. Whilst most cuts and scrapes heal up pretty quickly, if you break or dislocate your finger, it will take longer to heal and will probably be fairly painful, too.
There are a total of twenty-seven bones which make up the hand, with the hand being subdivided into three sections consisting of the wrist, palm and fingers.
The wrist is formed by eight carpal bones and these are arranged in two equal irregular rows. The carpal tunnel is formed where the bones and connective tissues merge and is where a number of tendons along with the median nerve pass.
Metacarpal bones form the palm of the hand and connect the wrist joint to the fingers via muscular attachments. Injuries to these bones are commonly associated with boxing or punching related injuries.
There are three bones within each finger called phalanges, of which there is the Distal, Middle and Proximal (Distal being the furthest away and Proximal being the closet). The fingers have no muscles in them and are fashioned from ligaments, with movement attributed to the pull of tendons from the forearm muscles. Finer finger movements are controlled via the intrinsic hand muscles. It is worth noting that the thumb only has two phalanges in the Distal phalanx of the thumb and the Proximal phalanx of the thumb.
Finger injuries are fairly common and can happen for all kinds of reasons. Falling over, trapping your fingers or even throwing a punch can cause a broken finger. It is thought that finger fractures actually account for around 10% of all fractures diagnosed.
However, you need to establish whether your finger is broken or sprained, as many symptoms of finger injuries are the same. Within 10 minutes your finger will most likely be stiff and painful as well as swollen, however you have injured it. If your finger looks as if part of the bone is pointing the wrong way (deformed), you’ve probably broken or dislocated it.
You may also experience numbness in the affected finger following the injury. This occurs where the swelling within the joint begins to compress the nerves which prevents signals being sent to the brain.
Where the bone is exposed this is referred to as a compound fracture. It will also be very painful to the touch. A sprained finger won’t look deformed and the pain will disappear on its own. Try to avoid using your finger for a day or two to see if the pain and swelling subsides.
If you suspect you have broken your finger then it is advisable to stop what you are doing and rest, whilst avoiding to move the affected finger. At this stage it may be unclear if you have broken your finger (though a fracture may be quite obvious) so there are a number of things you can do prior to diagnosis in the form of an x-ray.
Creating a splint or strapping the affected finger next to a functioning finger can offer a degree of protection. To counter any swelling you can lift your hand above the level of the heart, with this elevation helping to reduce the flow of blood to the affected region. Finally, you can use ice to help manage any swelling whilst also offering a degree of pain relieving benefits.
The NHS advise that in the event of a suspected broken finger you should visit your nearest minor injuries unit or walk in centre. If you are unsure what level of assistance is required then you should call NHS 111 for further information.
Finger injuries can be treated at A&E, or you could go to your local minor injuries unit, which deals with less life-threatening conditions.
In the event of a fracture it may be quite clear that there is a break or fracture i.e. where the bone is visibly misaligned. Where there is some uncertainty an x-ray will typically be offered to identify the root cause of the problem, from which a treatment plan can be devised. Even where a clear fracture has taken place an x-ray will still be performed to understand the extent of the fracture and how it is best remedied, either by realigning the bone or the use of metals pins.
Before you go to seek treatment, try wrapping ice in a cloth and holding it against your injured finger or making a splint to support your finger (a pen or lolly stick makes a good splint).
If you think you have broken your finger, you will need to have it x-rayed; if it proves to be the case, doctors will move your bone back into the right place. They can usually do this by using a local anaesthetic and without cutting into your skin. You’ll then probably need a splint, plaster cast or strap to hold it in place in order to heal. Only very occasionally, with serious fractures, will you need to have surgery.
After your treatment, you will need to keep your finger in position using the splint or plaster cast, and keep any dressings clean. You’ll usually then be offered a follow-up appointment, and you won’t be able to use your hand until your specialist has declared you healed.
A broken finger or any other type of finger injury can take up to six weeks to heal, so you may need to take some time out from work and from driving. Your doctor will tell you what you can and can’t do, depending on the severity of your injury.
Until you are given the all clear from a doctor it is important to avoid using the affected finger in order to minimise the risk of subsequent injury and setting you back in your recovery. During this time you can still continue to use ice and elevation of the hand above the heart to manage swelling. Pain killers can also be taken to help with any discomfort experienced.
Once your splint or cast has been removed you will typically be referred to a physiotherapist who will work with you on finger and hand exercises. It is important to keep your finger moving during this recovery period otherwise you could end up with very stiff joints which are difficult to mobilise.