Hand Fractures

The several treatment options for hand fractures will be discussed between the patient and the hand specialist. The best treatment depends on factors such as fracture type and patient age.

• Closed reduction without manipulation - If the fracture is in a good position, treatment may be as simple as wearing a cast for several weeks. The standard amount of time is 4-6 weeks depending on the type and severity of the fracture.
• Closed reduction with manipulation – If the fracture is not in good position, closed reduction with manipulation may be performed. This involves going to the operating room and having the fracture pushed back into place. Sometimes pins are inserted into the fracture to hold the pieces together. X-ray is used during the procedure to make sure that the bone fragments are lined up properly. A cast is usually applied in the operating room to hold the fracture in good position. Pins are kept in place for 4-6 weeks and removed in the office.
• Open reduction and internal fixation- This involves making an incision over a hand fracture that can’t be treated closed and then reducing the broken fragments into good position under direct visualization. The fracture is then held in place with either a plate and screws or pins.

Any cast or splint applied during surgery for repair of a fracture should be kept in place until the first follow visit. X-rays are taken at each office visit to monitor the position of the fracture and hardware and to monitor the healing of the bones. Therapy may be recommended to help to regain range of motion of the wrist and hand.