The five bones in your hand that connect your wrist to your thumb and fingers are called the metacarpal bones.
You have a fracture (break) in one or more of these bones. This is called a hand (or metacarpal) fracture. Some hand fractures require wearing a splint or a cast. Some need to be repaired with surgery.
Types of hand fractures
Your fracture may be in one of the following areas on your hand:
- On your knuckle
- Just below your knuckle (sometimes called a boxer's fracture)
- In the shaft or middle part of the bone
- At the base of the bone, near your wrist
- A displaced fracture (this means part of the bone is not in its normal position)
If you have a bad break, you may be referred to a bone doctor (orthopedic surgeon). You may need surgery to insert pins and braces to repair the fracture.
What to expect
You will likely have to wear a splint. The splint will cover part of your fingers and both sides of your hand and wrist. Your health care provider will tell you how long you need to wear the splint. Usually, it is for about 3 weeks.
If you had surgery, you may have a cast instead of a splint.
Most fractures heal well. After healing, your knuckle may look different or your finger may move in a different way when you close your hand.
Some fractures require surgery. You will likely be referred to a bone doctor (orthopaedic surgeon) if:
- Your metacarpal bones are broken and shifted out of place
- Your fingers don't line up correctly
- Your fracture nearly went through the skin
- Your fracture went through the skin
- Your pain is severe or becoming worse
Self-care at home
You may have pain and swelling for 1 or 2 weeks. To reduce this:
- Apply an ice pack to the injured area of your hand. To prevent skin injury from the coldness of the ice, wrap the ice pack in a clean cloth before applying.
- Keep your hand raised above your heart.
For pain, you can take ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), aspirin, or acetaminophen (Tylenol). You can buy these pain medicines without a prescription.
- Talk with your doctor before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
- Do not take more than the amount recommended on the bottle.
- Do not give aspirin to children.
Follow the instructions about your splint that your doctor gave you. Your doctor will tell you when you can:
- Start moving your fingers around more while wearing your splint
- Remove your splint to take a shower or bath
- Remove your splint and use your hand
Keep your splint or cast dry.
You will likely have a follow-up exam 1 to 3 weeks after your injury. For severe fractures, you may need physical therapy after your splint or cast is removed.
You can usually return to work or sports activities about 6 to 8 weeks after the fracture. Your health care provider or therapist will tell you when.
When to call the doctor
Call your doctor if your hand is:
- Tight and painful
- Tingly or numb
- Red, swollen, or has an open sore
- Hard to open and close after your splint or cast is removed
Also call your doctor if your cast is falling apart or putting pressure on your skin.
Boxer's fracture - aftercare; Metacarpal fracture - aftercare
Webb CW. Metacarpal fractures. In: Eiff MP, Hatch RL, eds. Fracture Management for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 4.
Update Date 5/15/2014
Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.