Integrated & Community Services - Hand Fractures

Introduction

You may or may not have needed surgery to fix this injury.

You may need or may not need a splint to immobilise your hand. This will depend on which bone(s) is fractured and severity.

A fracture is the medical term for a broken bone. Similarly, the Doctors may be treating you for a suspected fracture even though nothing is evident on your X-ray.

It is important you follow the instructions given to you as if not the injury could become worse, your fracture could displace leading to permanent deformity, loss of function, ongoing pain or the need for surgery.

If you have any questions or concerns at any time please ask your Hand Therapist.

Swelling

To reduce the swelling in your hand:

• When sitting or lying, support your arm and hand on pillows elevating it above the level of your heart
• If you are standing or walking a lot then a sling may be beneficial. If you use a sling, remove it 3-4 times a day to keep your shoulder and elbow mobile by doing the following exercises:

1. Lift your arm forwards out in front of you and up above your head, repeat 10 times
2. Bend and straighten your elbow fully 10 times

Remember to elevate your hand 24 hours per day until advised otherwise by your Hand Therapist or nurse, usually until 2 weeks following injury/surgery, but may be longer in some cases.

• You may apply an ice pack wrapped in a thin towel to the affected area; apply it every hour for a maximum of 10 minutes only, any longer may result in a cold burn to the area

Infection

If you have had surgery or have an associated wound on your hand please report IMMEDIATELY any signs of infection to Fracture Clinic, your GP or Hand Therapist, e.g.

• Increased pain over wound not related to exercise
• Increased redness
• Increased swelling
• Increased temperature of the wound and surrounding area
• Pain in arm
• Flu type feelings combined with any of the above

Splint information

• The splint has been fitted to allow the bone(s) to heal and ensure your hand does not develop any problems while being immobilised
• The splint will usually immobilise the joint above and below the fracture in your hand
• The splint must be worn at all times, day and night

You may remove your splint to clean your hand:

• If you have had surgery, you must keep your dressing and pin site dry; use a hand wipe or damp flannel to clean the surrounding skin but not your wound
• If you have no wounds, you may wash your hand in the bath or shower. However, you must not use your hand to wash yourself or such things as squeezing shower gel or shampoo. When reapplying the splint ensure your hand is completely dry to avoid damage to your skin
• To clean the splint either wipe the splint using a hand wipe or remove the straps and immerse the splint in lukewarm water. Do not use hot water as this may damage your splint. Rinse and towel dry the splint before reapplying
• Do not adapt the splint. If you have a problem with the splint or are experiencing the following, please contact the Hand Therapy department:
• A rash, red, blistered or broken skin
• The splint is rubbing causing a sore area
• Damp skin within the splint from sweat
• Increased pain
• Increased swelling
• The splint breaks or is damaged

Exercises

Keep joints that are not affected mobile whilst your injured finger/s supported. These exercises will need to be performed 10 times every 2 hours

• Bend and straighten your joints that are not affected
• Using your other hand, curl your finger/s in towards the palm of your hand. Make sure you include all 3 joints in the finger. Push your finger gently into resistance but not into pain, ideally all the way into your palm

At what stage you begin moving your fracture will vary greatly depending on the stability/severity of your fracture and if you have had surgery or any other injuries in your hand.

Driving or operating machinery

The DVLA state it is the driver’s responsibility to ensure they are safe and in full control of the vehicle.

We also advise you contact your insurance company to ensure you are still covered while driving with a splint on.

Sport, heavy lifting and manual work

Due to the nature of your injury and the chance of re-injury we do not recommend return to contact sports (or those where the finger is susceptible to injury) or heavy manual work until 10 weeks from the start of treatment of your injury.

Smoking

Smoking reduces the blood flow in your bone and hand which greatly delays healing. Therefore, we advise you to stop smoking at this time.

Please contact your stop smoking services in your area.

Smoking cessation service Oldham

• Phone 01619600255
• Text: “Oldham” to 62277 for free. The service will contact you

Transfer of Care

Please talk to your therapist if you would like your care to be transferred closer to home.

Guidelines

These are approximate guidelines and may vary on the severity and healing of your injury.

0 - 1 week:

Immobilised in cast, zimmer splint or buddy taped

1 - 3 weeks:

Conservative management: Immobilised in thermoplastic splint/ continue with buddy straps. ORIF: Follow post-surgery instructions.

3 - 6 weeks:

• Begin moving injured part of your hand
• ORIF: continue exercises
• Splint at night and protection
• Drive depending on pain and movement, consider with splint if safe to do so

6 weeks

• Return to non-contact sports including leisure swimming
• Children ≤ 12 years: contact sport if no pain on palpation of fracture site
• Light manual work
• Playing musical instrument, depending on pain and movement

10 weeks

• Return to contact sports/competitive or endurance swimming
• Heavy manual work

Contact details

If you have any queries or require any further information, then please contact us on 0161 627 8517.