HAND & FINGER FRACTURE REPAIR
Broken bones in the hand demand accurate diagnosis and the right treatment — whether that is a cast, a splint or surgical fixation. Correct alignment and stable fixation give the best chance of full functional recovery.
ABOUT HAND FRACTURES
Hand fractures — breaks in any of the 27 bones of the hand and fingers — are among the most common bone injuries. They are typically caused by direct trauma, a fall onto an outstretched hand, a crush injury or overuse. Pain, swelling, bruising and difficulty using the hand are the hallmark signs.
Not every hand fracture requires surgery. Many can be managed with immobilisation in a cast or splint, followed by physiotherapy. Surgery is indicated when the fracture is displaced, unstable, involves a joint surface, or cannot be reliably held in position by external support alone. In these cases, hardware — screws, plates, pins or wires — is used to restore correct alignment and hold the bone securely while it heals.
The specific surgical technique is determined by the bone involved, the fracture pattern and the individual patient’s needs. Following surgery, the hand is placed in a splint for six to eight weeks to protect the repair and support healing. A structured physiotherapy programme then restores strength, range of motion and normal function.
KNOWING WHAT YOU'VE BROKEN
Which bone is broken, and how, determines the treatment approach. Here are the three most commonly encountered fracture types.
METACARPAL FRACTURES
Fractures of the five metacarpals — the long bones connecting the wrist to the fingers — are the most common hand fractures. The ‘Boxer’s fracture’ of the fifth metacarpal neck is a well-known example. Many are managed with splinting, but displaced or angulated breaks require surgical fixation.
PHALANGEAL FRACTURES
Each finger has three phalanges (two in the thumb). Fractures here vary from simple undisplaced breaks to complex intra-articular injuries involving the finger joints. Fractures near or through a joint are more likely to require fixation to prevent lasting stiffness or deformity.
THUMB FRACTURES
Fractures at the base of the thumb — particularly Bennett’s and Rolando fractures — involve the critical carpometacarpal joint. Because of the thumb’s dominant role in grip and pinch, precise restoration of joint alignment is essential and surgery is frequently indicated.
PROCEDURE OVERVIEW
A clear summary of what to expect from assessment to recovery.
Surgery Time
Anaesthesia
Hospital Stay
Drains
Supporting Garment
The exact surgical approach — augmentation, reduction, lift or combination — is determined at consultation based on your individual anatomy and goals.
RECOVERY TIMELINE
Week 1
The hand is held in a protective splint immediately after surgery. A follow-up appointment at one week checks wound healing and confirms the fixation position on X-ray.
Weeks 2–4
The splint continues. Progress X-rays confirm bone healing is on track. Gentle finger movements may begin under physiotherapy guidance to prevent stiffness in the adjacent joints.
Weeks 4–6
Splint is discontinued once bone healing is confirmed. Physiotherapy intensifies with progressive exercises to restore range of motion, grip strength and functional movement. Return to light work is typically possible at four to six weeks.
Months 2–3
Strengthening exercises continue and grip progressively returns to normal. Most patients achieve full or near-full hand function. Return to heavier physical work and sport follows as strength is consolidated.
EXPECTED OUTCOMES
When the fracture is accurately reduced and securely fixed, the conditions for full functional recovery are in place from the moment surgery is complete.
WHY SURGICAL FIXATION
Surgery allows the bone to be precisely realigned under direct vision, restoring the anatomy that a cast alone cannot guarantee in displaced or unstable fractures.
Screws, plates, pins and wires hold the fracture securely while it heals, allowing earlier mobilisation and reducing the risk of the bone shifting into a malunited position.
Stable internal fixation allows physiotherapy to begin earlier than with cast management alone, reducing stiffness and improving the final range of motion — particularly important for fractures near joints.
The choice of hardware and surgical approach is guided by the specific bone, fracture pattern and your functional requirements — whether that is returning to manual labour, a precision trade, or high-level sport.
CAST OR SURGERY?
Most hand fractures can be managed successfully without surgery. But certain fracture characteristics mean that a cast or splint alone cannot reliably keep the bone aligned during healing — and a malunited hand fracture can permanently affect grip, strength and appearance. The following fracture patterns are the most common reasons surgical fixation is recommended.
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I fractured my metacarpal playing football. Professor Hindocha fixed it with a plate and I was back training at ten weeks. The hand feels completely normal.
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A crush injury at work left me with a broken finger that needed pinning. I was back at a desk within five weeks. The physio programme made a huge difference to getting full movement back.
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I was seen quickly after my accident and the surgery was straightforward. Professor Hindocha explained exactly what he had done and what to expect. Excellent care throughout.
DO YOU NEED SURGERY?
Many hand fractures heal well in a cast or splint. Surgical fixation is recommended when the fracture cannot be reliably managed non-operatively. Indicators include:
THE WORK STARTS AFTER SURGERY
Surgical fixation restores the bone’s anatomy — but the soft tissue around it — tendons, ligaments, joint capsule, skin — has also been through a significant insult. Without a deliberate rehabilitation programme, stiffness, weakness and swelling will persist long after the bone itself has healed.
Physiotherapy begins during the splinting phase for unaffected joints and intensifies once the splint is removed. A specialist hand physiotherapist guides you through exercises designed to recover movement, grip, and the fine motor control needed for work and daily life.
RELATED HAND INJURIES
Specialist hand and upper limb trauma managed at the same clinic.
HAND SURGERY
Tendon cuts or ruptures caused by lacerations or forceful trauma, requiring urgent repair.
HAND SURGERY
Avulsion of the deep flexor tendon from the fingertip, common in contact sport and physical work.
HAND SURGERY
Rupture of the extensor tendon at the fingertip causing the finger to droop and lose the ability to straighten.
GET THE RIGHT TREATMENT QUICKLY
Accurate diagnosis. The right fix for your fracture.
If you have sustained a hand injury and suspect a fracture, an early specialist assessment will confirm the diagnosis, determine whether surgery is needed, and ensure the bone heals in the correct position. Malunited fractures managed incorrectly can result in permanent stiffness or deformity that is far harder to correct later.
FREQUENTLY ASKED QUESTIONS
The questions patients ask us most about hand fracture treatment.
