Finger Fracture

CONDITION

A fracture is a broken bone. In each of your fingers, there are three finger bones connected at the joints by strong bands of tissue called ligaments. Tendons, which are tough cords of tissue that connect muscle to bone, move your fingers.

  • Finger fractures (Figure 1) are among the most common fractures seen in doctor’s offices.
  • Fractures to the tip of your finger occur most often, followed by fractures to the finger bone closest to the knuckle on the back of your hand.
  • Fractures near or within the joints are more serious than fractures between the joints.
  • Sometimes finger fractures can cause the tendons that move your finger to tear away from the bone.
  • Many fractures are work- or sports-related.
Figure 1.

CAUSES

Causes are varied and include:

  • direct impact or trauma to any part of the finger
  • jamming your finger, such as may occur when a basketball hits the finger tip
  • twisting injuries
  • getting your finger caught between two objects
  • getting your finger bent back too far (hyperextension) or bent forward too far (hyperflexion)
  • crush injuries, such as may occur when something heavy falls on your fingertip.

SYMPTOMS AND SIGNS

If the break is in your fingertip:

  • Something probably crushed your fingertip or you jammed it.
  • Your fingertip is swollen, painful and bruised.
  • Your fingernail may be torn or there may be a purplish collection of blood under your nail that causes severe pain.
  • Sometimes, the skin around your fingertip may be torn and you may have scrapes or cuts.
  • You may have numbness or loss of sensation to all or part of your fingertip.
  • You may have a hard time bending or straightening the joint nearest your fingertip.
  • Sometimes, your fingertip looks crooked.

If the fracture is to the middle bone in any of your fingers:

  • You probably had a direct hit or blow to the back of the middle finger or jammed that finger.
  • You will have pain, swelling and, sometimes, bruising over the fractured bone in your middle finger.
  • You may have a hard time bending or straightening your middle finger.
  • Your middle finger may look crooked.
  • There may be a lot of swelling over one of the joints in your middle finger.
  • When you try to make a fist, the tip of your middle finger may point in a different direction than your other fingers.
  • You may have numbness out beyond the middle bone in any finger or over your fingertip.

If you’ve broken one of the finger bones closest your hand or the knuckle on the back of your hand:

  • There may have been a direct blow to the back of your finger.
  • You may have twisted or rotated your finger wrong, especially if you caught it in or on something.
  • Something may have fallen on your finger and crushed it.
  • You will have pain, swelling and, sometimes, bruising over the fracture.
  • Your finger may look crooked.
  • Where the fracture is, you may notice a lump on the palm side of your finger.
  • You may have a hard time bending or straightening your finger.
  • More often than with other finger fractures, when you gently try to make a fist, the tip of your injured finger points in a different direction than your other fingertips.
  • If you have injured a nerve in your finger, you may have numbness or loss of sensation beyond the fracture area.

WHEN TO CALL YOUR DOCTOR

Call your doctor right away (day or night) if:

  • You have severe pain and swelling.
  • Your finger looks crooked or bent in the wrong direction.
  • Your finger is numb or you have lost feeling in any part of your finger.
  • Your finger looks pale or grey.
  • You have a lot of swelling over any of your finger joints.
  • You can’t bend or straighten your finger properly.
  • You notice any abnormal, painful lumps along your finger.
  • When you gently try to make a fist and look at your fingertips, your injured finger points in a different direction than your other fingers.

Call your doctor during regular office hours if you have only mild to moderate pain and swelling AND:

  • Your finger is not crooked or bent wrong.
  • You have no numbness or discoloration of your finger.
  • Your swelling and bruising is only mild.
  • You can bend and straighten your finger reasonably well without much pain
  • Your fingertips all point in the same direction when you gently try to make a fist.

SELF-CARE AT HOME

  • Do NOT pull on or try to straighten you finger if it is crooked or looks bent.
  • If your finger is not bent or deformed, you may buddy-tape your injured finger to the largest uninjured finger next to it. Wrap a small piece of athletic tape, which can be bought at any drug store, around both fingers (Figure 2). Place the tape between, not across, your finger joints.
  • Figure 2.
  • If you finger hurts too much with buddy-taping or with bending and straightening it, you can place it the most comfortable position and put on an aluminum finger splint. Most drug stores sell finger splints.
  • You may take a fast-acting, anti-inflammatory such as ibuprofen (Advil®, Motrin®) for pain and swelling. (See the labels for dosing and risks.)
  • Keep your finger elevated above your heart as much as possible to reduce swelling and throbbing.
  • You may apply an ice pack or cold pack to the swollen area over your finger.
    • Because the finger skin is very thin and the nerves in your finger are sensitive, place a thin cloth between the cold pack and your skin to avoid frostbite and nerve injury.
    • You may ice for 15 to 20 minutes at a time, letting your finger warm up to normal temperature between icing.

FOR MORE INFORMATION

REFERENCES

Last reviewed: November 2009

Last revised: November 2009