Metacarpal fracture of the hand

Your injury may be referred to as a fracture, break or crack. These terms all mean the same thing.

When you have a fracture, it's not just the bone that's affected. You'll also have injured some of the soft tissues around it. Soft tissues include the:

• muscles
• ligaments
• tendons
• nerves

Recovery times

After a metacarpal fracture of the hand, most of the healing happens between 3 to 4 weeks.

It's normal to have aches and discomfort beyond this. This often happens when you try activities you haven’t done for a while.

It's also normal for the area to be more sensitive for several months after the injury.

What can affect your recovery?

There are some things that might affect your recovery.

Smoking

Smoking affects all your tissues and slows facture healing times. In some people, it can stop healing altogether.

Stopping smoking as your fracture heals will help to ensure the best recovery.

Get help to stop smoking.

General Health

Some medical conditions, like diabetes, may slow down the healing process.

Eating a healthy diet and keeping yourself active will help your recovery.

Medication

Some medications can slow down fracture healing. If you have concerns about your medication talk to a healthcare professional.

Anti-inflammatory medication, like Ibuprofen or Naproxen, have been shown to delay healing.

What to expect after a metacarpal fracture of the hand

A metacarpal fracture of the hand is usually a minor fracture. However, it can be debilitating as you can't use your hand normally.

Even though it will be uncomfortable, it's important to move the fingers early on. This will improve the function of the hand and help your recovery.

Pain

It's normal to have some discomfort in the areas around your fracture. The areas affected can be:

• other soft tissues
• nearby joints
• areas that have been immobilised

Pain can change from day to day and it doesn’t always depend on what you're doing. It's common to have pain at rest.

It's normal to have some pain even when your fracture has healed. Some people also experience discomfort in the fracture site during colder weather.

Your local pharmacy can give you advice on managing pain after a fracture.

Swelling

Swelling is the start of healing. It's normal to have swelling near the fracture. Often this will spread down to your fingers.

The swelling can change with:

• your position
• your activity
• the time of day

It's normal to have some swelling even after your fracture has healed. This can last for several months.

There's usually a bony lump at the fracture site. This may reduce slightly with time.

You may notice that your knuckle is not as prominent because it's common for the bone to shorten as a result of this injury.

How to manage swelling

Having a lot of swelling can become uncomfortable or limit your movement. However, there are some things you can do to help reduce the swelling. You can:

• raise your arm above your heart when you're resting - you can do this by supporting it with pillows
• keep the other joints in your arm and hand moving normally
• avoid too much rest or too much activity
• massage the swelling from the tips of the fingers towards the armpit

Bruising

It's normal to have bruising. Bruising can be widespread and may appear a long way from your fracture.

Bruising can be very purple to start with and may change colour as you recover. Usually, you'll see it between the web spaces of your fingers.

Getting back to normal activities

In general, you should pace yourself when it comes to getting back to normal. Only do activities as you feel able.

Driving

You should contact your insurance provider before driving as your injury may affect your insurance.

Once you're out of your splint, the general advice is that you must be able to safely perform an emergency stop or manoeuvre.

You should always be in full control of your vehicle.

Work

Your return to work will depend on the type of work you do and your employer. It may be possible to discuss a phased return to work or changed duties.

You don’t need to see a healthcare professional to return to work.

Daily activities

Keep doing any activities you're able to, as your pain allows. Over time, gradually increase what you do.

Reduced flexibility and strength may make things more difficult to start with. This will get better as you slowly build up to all your usual activities.

Mood

Frustration or low mood after your injury is normal. As you get back to normal life this will get better. If this is a major issue discuss it with your GP.

Falls

Loss of confidence is common after a fracture. Get advice on:

• preventing falls
• 6 exercises for staying steady

Bone scanning

You may be sent a letter inviting you for a scan of your bone density after a fracture.

It's routine to be assessed for any further risk of fracture, especially if you:

• are over the age of 50
• have increased risk factors for fracture

Recovery plan

There are things you can do to help your recovery after a metacarpal fracture.

0 to 2 weeks since injury

You may have one finger taped to another (buddy taped) but try to move the joints that are taped as far as you're able.

Just after your injury, you should:

• manage your pain and swelling
• use your hand for light activities
• avoid heavy lifting
• avoid picking up hot items

2 to 6 weeks since injury

Between 2 to 6 weeks after your injury, buddy taping should be removed.

At this time, you should:

• continue to increase your movement with these exercises for your injured hand
• try and move the 3 hinged joints in each finger hourly but don't force the movement
• practice using the base of the thumb joint to roll and touch the fingers
• gradually increase the use of your hand in normal daily activities

6 to 12 weeks since injury

At 6 to 12 weeks after your injury, you should:

• return to full function
• resume normal day to day activity

If you're a boxer, check with your doctor before starting any boxing. It can take closer to 3 months before you'll be able to do any higher impact activity.

Exercises for your hand

You can follow some exercises for your injured hand.

Try and do exercises regularly throughout the day, ideally every hour.

The exercises should be started 2 to 6 weeks after your fracture.

Help and support

If your wrist, hand or finger problem hasn’t improved within 6 weeks of following this advice, it’s a good idea to talk to a healthcare professional about your symptoms.