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Overview of finger, hand, and wrist fractures

Sandeep Sebastin, MMed, FAMS
Kevin C Chung, MD, MS
Shimpei Ono, MD, PhD
Section Editors
Patrice Eiff, MD
Charles E Butler, MD, FACS
Deputy Editor
Jonathan Grayzel, MD, FAAEM


Primary care of hand fractures involves accurate diagnosis, pain control, reduction as indicated, immobilization of the fracture, appropriate referral to a hand surgeon, and appropriate rehabilitation once the fracture is healed.

This topic provides an overview of the initial evaluation, identification, and management of finger, hand, and wrist (carpal) fractures. Detailed discussions of specific injuries are found separately. (See "Scaphoid fractures" and "Distal radius fractures in adults" and "Lunate fractures and perilunate injuries" and "Overview of carpal fractures" and "First (thumb) metacarpal fractures" and "Overview of metacarpal fractures" and "Proximal phalanx fractures" and "Distal phalanx fractures" and "Middle phalanx fractures" and "Evaluation of the patient with thumb pain".)


Fractures of the phalanges and metacarpals are among the most common fractures of the skeletal system and account for 10 percent of all fractures [1]. Along with fractures of the carpal bones, they represent a substantial portion of upper extremity fractures [2]. The distal phalanx is the most commonly fractured bone in the hand, followed by the metacarpals [3]. The bones of the hand and wrist are shown in the figure (figure 1).

Metacarpal fractures are seen more often in adults, whereas phalangeal fractures are more common in children [2]. Approximately 20 percent of metacarpal and phalangeal fractures are intra-articular [3].


Before examining a hand fracture, a quick assessment to rule out any other associated injuries should be carried out. For patients without apparent life-threatening injuries who appear appropriate for office management, assessment begins with a focused history. Analgesia is sometimes needed before a history can be obtained.

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Literature review current through: Nov 2017. | This topic last updated: Jun 19, 2017.
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