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		Fractures & Dislocations of the Hand & Wrist > Fractures of the Metacarpal and Phalanges (The Tubular Bones of the Hand) What are Fractures of the Metacarpals and Phalanges? The metacarpals are the five bones in wrist leading to the fingers. The phalanges are your finger bones. Fractures of any one of these bones may cause bleeding into tissues, which causes swelling. If the fracture is closed (not through the skin), elevate the limb and ice the swelling for 10 minutes at a time to avoid tissue damage. There are many types of fractures. Some of them include: Comminuted fracture: more than two bone fragments at the fracture. Compound (open) fracture: one end of the broken bone has broken through the skin. Closed fracture: neither end of the broken bone has pierced the skin. Compression fracture: the bone has broken from extreme pressure and has been smashed. Impacted fracture: the ends of the broken bone are driven into each other. Avulsion fracture: the muscle has pulled a portion of the bone away from where it was originally attached. Pathological fracture: the bone has been weakened or destroyed by disease so that the already weakened bone breaks easily. If a metacarpal or phalange is broken, swelling will appear over the fracture site, and there should be a decreased range of motion. The involved finger may appear shortened, or the knuckle may be depressed. Causes of Fractures of the Metacarpals or Phalanges? Fractures can occur in many ways: falls, contact sports, force from a blow, and trauma. Symptoms of Fractures of the Metacarpals or Phalanges? Pain Tenderness Swelling Deformity Decreased range of motion Treatments of Fractures of the Metacarpals and Phalanges? If the doctor suspects a fracture, he or she will order x-rays. The treatment depends on what kind of fracture you have. If the bone pieces are lined up well, surgery may not be necessary and your finger or wrist may be set in a splint or cast (three weeks for phalangeal fractures and four weeks for metacarpal fractures). In the worst fractures, physicians will need to perform surgery and may use metal pins, screws, or plates to hold pieces of bone together. You may be given a splint for your arm for a few days until the swelling begins to go down. Then your arm will be put in a cast for 4 to 8 weeks. Patients should expect stiffness in their fractured joints in both cases after treatment. For all fractures, your doctor may prescribe anti-inflammatory medications or other pain medications. At home, to control pain and swelling, you should elevate your hand on a pillow or the back of a chair as often as possible for the first 2 to 3 days. You may place ice packs over the cast for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days, but do not get any plaster casts wet. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN
Curtis National Hand Center. Union Memorial Hospital. 3333 N. Calvert St, Baltimore, MD 21218. p: (410) 235-5405. f: (410) 467-5459