The 5 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.

Boxer's fracture - aftercare; Metacarpal fracture - aftercare

Your fracture may be in one of the following areas on your hand:

• Your knuckle
• Just below your knuckle (also called a boxer's fracture if it is in your small finger)
• The shaft or middle part of the bone
• At the base of the bone, near your wrist

Your fracture may also be a displaced fracture (this means part of the bone is not in its normal position) or an angulated fracture (in which the normally straight bone has a bend to it).

If you have a bad break, you may be referred to a bone specialist (orthopedic surgeon). You may need surgery to insert pins and plates to repair the fracture.

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.

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 an orthopedic surgeon if:

• Your metacarpal bones are broken and shifted out of place
• Your fingers do not line up correctly
• Your fracture nearly went through the skin
• Your fracture went through the skin
• Your pain is severe or becoming worse
• Your fracture extends into a joint

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 provider 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 or by your provider.
• Do not give aspirin to children.

Follow your provider's instructions about wearing your splint. Your provider 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. For example, when you shower, wrap the splint or cast in a plastic bag.

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 8 to 12 weeks after the fracture. Your provider or therapist will tell you when.

Contact your provider 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 contact your provider if your cast is falling apart or putting pressure on your skin.

Gaston RG. Fractures of the metacarpals and phalanges. In: Wolfe SW, Pederson WC, Kozin SH, Cohen MS, eds. Green's Operative Hand Surgery. 8h ed. Philadelphia, PA: Elsevier; 2022:chap 7.

Ruchelsman DE, Bindra RR. Fractures and dislocations of the hand. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 40.