Fractured Finger: Signs, Symptoms & What to Do

Clinical Signs of Finger Fracture

• Pain: Immediate, localized, worsened by movement/pressure.
• Swelling: Rapid, often within minutes-hours; may obscure anatomy.
• Bruising (Ecchymosis): Subcutaneous bleeding; appears hours later.
• Deformity: Angulation, rotation, shortening — compare to contralateral finger.
• Tenderness: Focal over fracture site (vs. diffuse in sprain).
• Limited ROM: Pain-blocked or mechanical block (displaced fragment).
• Malrotation: Finger crosses over neighbor when flexed — pathognomonic for rotational deformity.
• Open Fracture: Bone through skin — surgical emergency (irrigate, abx, OR).

Subtle Fractures

• Non-displaced phalanx fractures may have minimal deformity.
• Volleyball finger (mallet finger) — extensor tendon avulsion ± fracture.
• Jersey finger — FDP avulsion (cannot flex DIP).
• Boxer's fracture — 5th metacarpal neck (not finger, but often grouped).

Immediate Steps

1. Ice, elevation, immobilization (buddy tape to adjacent finger if stable).
2. Remove rings immediately (swelling → compartment syndrome).
3. X-ray (AP, lateral, oblique) — only way to confirm and characterize.

Treatment by Type

• Non-displaced: Buddy tape / splint 3–4 wks.
• Displaced/angulated: Closed reduction + splint/cast.
• Unstable, intra-articular, rotational, open: ORIF (K-wires, plates, screws).

Rehab

Early protected motion (per surgeon) prevents stiffness. Hand therapy often needed. Return to sport: 6–8 wks (contact), 4–6 wks (non-contact).