Fracture of the little finger on the hand: symptoms, how long it takes to heal

Last Updated on 06/23/2017 by Perelomanet

Fractures often occur in everyday life. One of the most vulnerable places susceptible to such injury are the hands and fingers. The most common fracture of the little finger occurs.

In the above case, it is very important to promptly determine the presence of such an injury and seek help from a specialist. Otherwise, the finger may become deformed and remain that way for life, which will bring not only aesthetic discomfort to the person, but also affect the normal, full functioning of the hand.

Types of injury

A fracture of the little finger on the hand can occur in several ways:

Fracture – the bone of the injured phalanx is partially broken (the size of the fracture does not exceed ½ the diameter of the bone).
A crack is a break that occupies a significant area of the bone, but a larger area remains intact and unharmed.
Cracking - the entire surface of the bone (both along and across) is subject to a large number of cracks.

A finger fracture can be either traumatic or pathological. A traumatic fracture occurs as a result of some kind of injury to a person (a heavy object falling on the fingers, the person falling on his hand, etc.). Pathological injury can occur as a result of a person having any pathological disease that affects bone health (for example, tuberculosis, osteoporosis, and others).

A fracture of a finger can be open (the integrity of the soft tissue is broken) or closed (the integrity of the soft tissue is broken).

The phalanx of the finger may be susceptible to the following types of fractures:

oblique - the fracture occurs at an acute angle relative to the longitudinal axis of the bone;
transverse - the fracture occurs in a direction perpendicular to the longitudinal axis of the bone;
comminuted - a broken bone is divided into several fragments, which can remain inside the soft tissues or rupture the latter;
longitudinal - the fracture occurs in a direction parallel to the axis of the bone;
helical - fragments of damaged bone unfold in a direction parallel to their natural location.

A fracture of the little finger can occur with or without displacement. In the first case, the displacement of the fragments can occur both inside the soft tissues present inside the finger and tear them, while the broken bone looks out.

Displacements of fragments of the injured bone can occur along the width of the finger, along its length, can be displaced at an angle or be rotational. Also, the fracture can be combined and then the bone fragments can move in several directions.

Fracture of the hand

Fracture of the radius of the arm

The most common fracture of the hand is a fracture of the distal epimetaphysis of the radius (“in a typical location”) in combination with a fracture of the styloid process of the ulna.

This type of injury is subject to a certain seasonality: the number of victims especially increases during icy conditions. Most often it happens when falling on an outstretched arm.

Fractures of the radius according to the classification of the Association of Osteosynthesis (AO) are divided into three types - A, B and C depending on the complexity: from A (the simplest extra-articular fractures of the radius without displacement) to C (complex comminuted intra-articular fractures of the radius with pronounced displacement) . Each type of injury has its own treatment method.

Diagnosis of a fracture of the radial head is not difficult: the initial examination reveals deformation, pain, and pathological mobility. A fracture of the hand (to clarify the type and complexity of the injury) requires radiography, which gives an adequate picture of the existing situation. In some cases of displaced intra-articular radius fractures, computed tomography is sometimes performed for greater visualization.

Treatment of a broken arm

When treating closed Type A radius fractures (called impacted radius fractures), closed reduction and a plaster cast are usually used.

One of the problems that can arise with the conservative method of treating a fracture of the radius is secondary displacement of fragments. Therefore, after repositioning and applying a plaster splint, it is necessary to ensure that the bandage does not squeeze the arm, lies quite tightly, but not tightly, and after the swelling subsides (on the 5-7th day), it is necessary to perform an x-ray control to make sure that secondary displacement has not occurred.

If there is a tendency to secondary displacement, then surgical treatment is recommended. For this purpose, several osteosynthesis techniques are used:

osteosynthesis with three knitting needles according to Kapandzhi;
osteosynthesis with plates with angular stability, which are designed specifically for the distal radius.

Fractures of types B and C in 99% of cases tend to be displaced, that is, they are obviously unstable. Depending on their location and the degree of damage to the articular surface, two surgical treatment options are possible:

osteosynthesis with plates with angular stability for the distal radius;
application of distraction devices (for intra-articular, severely comminuted fractures), which are used when applying a plate causes technical difficulties associated with the presence of a large number of small fragments, osteoporosis, etc.

Osteosynthesis with wires and plates is usually combined with the mandatory application of a plaster cast for several weeks. This is necessary for less trauma to the tissues in the surgical area, for better reduction of swelling and reduction of pain.

Also in the postoperative period it is necessary to use physiotherapy and exercise therapy.

Recently, there has been a tendency that during any operation for intra-articular injuries (displaced fracture of the radius), the reposition of fragments must be controlled using an arthroscope, which makes it possible to completely eliminate the displacement of fragments and significantly reduce the risk of developing deforming arthrosis.

The most serious complication of injuries of this location is complex regional pain syndrome, which develops, as a rule, with conservative treatment, but also occurs after severely traumatic operations.

With conservative therapy, this syndrome occurs in a situation where repeated and traumatic attempts at reposition have been made, or an unmodeled plaster cast has been applied. In this case, the bandage compresses the injured limb, which leads to disruption of blood supply and, as a consequence, entails the development of complex regional pain syndrome.

Scaphoid fracture

Fractures of the scaphoid bone of the hand are also very common. They can be either isolated or associated with a dislocation of the hand, transscaphoid-perilunar dislocations. The choice of treatment method for such a fracture of the arm depends on the time that has passed since the injury and on the degree of negative changes in the area of the scaphoid bone.

If the patient has a fresh fracture of the arm, treatment (in the absence of displacement) is indicated conservatively. A plaster cast is applied, after 6 weeks an X-ray control is performed, and if the image shows no signs of fusion, osteosynthesis of the scaphoid bone is performed. In the case of transscaphoid-perilunar dislocation, elimination of the dislocation, reposition of the scaphoid bone and osteosynthesis with a special titanium screw are performed, ensuring adequate compression of the fragments, which is necessary for fusion.

In more advanced cases, when cystic bone reconstruction is present, treatment combines various options for bone grafting.

If there are pronounced signs of deforming arthrosis in the area of the scaphoid, various treatment options for bone fractures are also possible:

removal of the scaphoid bone and the formation of partial arthrodeses of the wrist joint;
bone prosthetics using pericarbon prostheses (very common in foreign practice);
complete arthrodesis of the wrist joint - in the event that no other options bring relief to the person and do not help reduce pain.

For diagnosis, in addition to visual examination, radiography and computed tomography are indicated. In some situations, it makes sense to conduct angiography of the injured limb to determine the degree of vascularization (blood supply) of the damaged bone.

Metacarpal fractures

Metacarpal fractures are an injury that most often occurs when the fist hits hard objects. Treatment for this type of injury depends on its location.

In case of a fracture of the head of the radial bone, it is advisable to perform osteosynthesis with knitting needles or osteosynthesis with a plate.

A fracture of the diaphyses of the metacarpal bones is treated using osteosynthesis with pins (stable osteosynthesis) according to a technique developed under the guidance of Professor V.F. Korshunov. This is a fairly simple and effective technique that allows you to make a reposition using two small incisions (1-1.5 cm each) and insert a pin into the bone. This technique allows you to fully restore hand function almost a week after surgery. Six months after installation, if there are signs of fusion in the fracture area, the pin is removed.

A fracture in the area of the base of the metacarpal bones is fixed mainly with the help of knitting needles. Oblique and helical fractures can be fixed with minifragment screws in combination, if necessary, with plates for external osteosynthesis.

Fractures of the phalanges of the fingers: osteosynthesis with wires and microscrews for mini-fragments

Damage to hand tendons

For fresh injuries to the tendons of the hand (both flexor and extensor tendons), a suture is performed. Unfortunately, when applying a suture to the flexor tendon, there is a certain difficulty in that the tendon is usually damaged in the area of the fibrous canal, in the “dead zone”. A seam in this area often does not lead to the desired result. Recently, special sutures have been developed that allow the patient to be quickly activated in the postoperative period to fully restore the functions of the injured limb.

In long-standing situations of flexor tendon injuries, a two-stage repair is performed. At the first stage, scar tissue is removed from the tendon canal area and a special silicone prosthesis is placed there. Six months later, after a new tendon canal has formed around it, it is replaced by a graft of another tendon (either from the foot or hand).

Nerve damage

Damage to the radial nerve most often occurs during humerus fractures. Traumatic damage to the nerve can occur even if there was no direct impact on it - only due to cicatricial processes in the area of wound healing. Treatment of damage to the radial nerve in this case is carried out using surgery aimed at releasing the nerve from compression.

In all cases of fresh peripheral nerve injury, an epineural suture is necessary. Only in this case can we count on the most complete restoration of the function of the damaged nerve.

In cases of old damage, in the absence of a nerve defect after its isolation from scar tissue, it is possible to perform a secondary epineural suture. If there is a nerve defect, it is necessary to perform nerve plasty, most often with a graft from n. suralis.

Symptoms

The main signs of a fracture of the indicated finger and symptoms of bone cracking may be as follows:

the appearance of a strong tumor directly over the entire area of damage;
the presence of subcutaneous hemorrhage visible to the naked eye;
limitation of the functional activity of the little finger;
severe pain when trying to make motor movements with the injured finger;
the appearance of severe swelling in the injured area of the little finger;
if the fracture is open, bleeding may occur;
deformation of the damaged phalanx of the little finger;
in cases of a fracture of the upper phalanx of the finger, hemorrhage under the nail plate is visible;
the victim feels the movement of fragments that appeared in the finger as a result of the fracture, and hears their crunch when pressing on the damaged little finger;
the injured little finger becomes much shorter than before the injury;
a bony protrusion became very noticeable on the injured finger.

If a fracture of the little finger occurs in the joint area, it can be determined independently by only one sign - the inability to carry out any motor movements with the injured finger. Only radiography will help determine such an injury.

Complications

The main complications in the treatment and rehabilitation of little finger fractures:

improper fusion of bone fragments;
formation of contractures;
impaired functionality of the finger, arm, hand;
pain when moving (the bone has not fused correctly);
infection in complicated, open fractures;
development of arthritis, arthrosis;
increased fragility of bone tissue, repeated fractures;
shortening of the finger;
formation of a false joint;
disturbance of innervation;
pathological swelling;
chronic aching pain (especially when climate conditions change);
extremely rarely – traumatic toxicosis, shock.

Providing first aid to the victim

It may seem that getting a fracture of the phalanx of the little finger is quite difficult, but this is not so. It is easier than ever to break this finger, since its bones are the thinnest compared to the other fingers.

If a person experiences signs of a broken finger, he needs competent first aid. The injured limb must be immobilized. But this must be done as carefully as possible, since in the case of comminuted fractures or these displacement injuries, careless actions can displace bone fragments and damage nerve endings, as well as tear soft tissue more severely.

You can immobilize an injured little finger using any available items that are suitable for a homemade splint. These may include ballpoint pens, pencils, rulers, branches, etc. The resulting splint is fastened with a bandage or any available fabric, which is torn into pieces for this purpose.

Treatment

Typically, such a fracture is treated conservatively without surgery, then the little finger is only immobilized and the necessary period of time is expected for complete healing of the bone.

Osteosynthesis of the phalanx of the finger with a screw

But an open fracture of the little finger, which occurs due to the release of broken bones displaced relative to each other, requires surgical intervention, in which surgeons fasten the disparate parts of the bone together using surgical devices: screws and bolts. After the operation, a cast is placed on the finger and immobilized with a special splint (called a Beler splint) to prevent the possibility of deformation of the broken bone.

After such an injury, all patients are concerned about the question of how long the cast should be on the finger and how quickly the finger heals in such cases? The plaster is removed approximately 5-6 weeks after the patient’s injury and the patient is prescribed physiotherapeutic procedures that promote accelerated restoration of the full functioning of the injured finger and complete healing of the bone itself.

Fracture of the hand

For fixation, we use the most modern dressing materials, including polymer (plastic) plaster. This is an excellent replacement for traditional plaster - the polymer bandage not only provides excellent fixation, but also, thanks to its properties, allows you to feel comfortable during the recovery period. Lightweight, moisture-resistant and breathable, the bandage easily conforms to the contours of the body, minimizing discomfort.
Fixation of displaced fragments occurs using plates and pins made from the highest quality materials.
The choice of anesthesia depends both on the patient’s condition and physiological characteristics, and on his desire - we provide all types of anesthesia, including the most modern, xenon. Optimal anesthesia is selected based on all conditions.

The intensive care unit of the clinic, equipped with the most modern equipment, allows, if necessary, to monitor the patient’s condition after surgery.

The rehabilitation program of the rehabilitation course is developed only on an individual basis. Rehabilitation includes physical therapy, therapeutic exercises and other therapeutic procedures, through which recovery after a fracture occurs as quickly as possible.

If a child is injured

Detecting a fracture of the little finger in children is complicated. The reason for this is the presence of uncovered growth zones. As a result, it is quite difficult to determine the specific location of the fracture. Even an x-ray procedure will not bring the necessary results.

In such cases, the doctor has no choice but to make a diagnosis based on the existing signs and his own observations. Usually, a healthy finger is compared with an injured one, and the presence of a fracture is determined by the existing differences (difference in length, presence of bumps on the finger, which are bony protrusions, etc.).

A special immobilizing splint or plaster is applied to the patient’s injured little finger in a certain position: the finger should be slightly bent. Both the plaster cast and the immobilizing splint must necessarily cover the entire finger: from the upper phalanx to the base of the little finger. It takes less time for a child to completely heal an injured finger than for an adult. This period can be only 2-3 weeks.

Rehabilitation

1.5-2 months after the fracture, you can begin rehabilitation measures aimed at accelerating bone healing and complete functional restoration of the injured little finger. Usually the patient is prescribed physiotherapeutic procedures. But in addition to them, you can restore the motor capabilities of the injured little finger at home. To do this, you can use the following methods:

Touch the grains with the fingers of the injured hand and place them on different plates, while trying to get as much grain as possible into your hand.
Buy an expander and squeeze it in your hand 20-25 times several times a day.
Sit on a chair located at the table. Place your hand on the table, palm down. Raise and lower the injured little finger so that the rest of the palm does not come off the table;
Soak your injured hand in a bath of sea salt. Carrying out such manipulation at least 2-3 times a week will contribute to the accelerated healing of the broken phalanx of the little finger.

Such simple but regularly performed manipulations will help to quickly restore motor activity of the limb.

What you should pay special attention to

Once the cast or splint is removed, the injured little finger should gradually return to its normal state and gradually regain full function. But there are situations when, after removing the plaster or immobilizing bandage, there are bruises or bruises on the little finger, and the finger also causes aching pain and has a swollen appearance.

Such symptoms may be a sign of improper fusion or a prolonged stay of the little finger in a stationary position. Therefore, if there are any, it is necessary to immediately contact a specialist who will prescribe the patient an x-ray and identify any deviations.

Causes

A fall on the upper limb is the most common precipitating factor. Also, do not overlook the powerful physical impact on the phalanx - blow or pressure. In any case, diagnosis must be timely, otherwise complications during treatment are guaranteed.

It is important to mention that damage affects the phalanges of the little finger and the joints equally. Diagnosis of such herbs is extremely difficult, since visual symptoms are not always present.

In such situations, it is worth paying attention to the presence of pain and discomfort, as well as directly to the level of functionality of the finger.