Finger Fracture: Symptoms, Treatment, and Recovery Time for a Finger Fracture

A finger fracture (medically known as a finger fracture or fracture of the finger) is an injury to the bone of one or more fingers. Along with wrist fractures (distal radius fractures), it is one of the most common fractures of the upper extremities (= hand and arm).

A broken finger is painful. Since sprains and contusions cause very similar pain, these types of injuries are difficult to distinguish from one another.

Other symptoms of a broken finger include swelling and bruising (hematoma). In addition, the person affected may have limited or no ability to move the broken finger. Swelling usually occurs within a few minutes of the injury.

However, these symptoms also occur with sprains and other finger injuries. Therefore, doctors should take an X-ray to confirm the diagnosis.

This allows the doctor to assess, from multiple angles (medically: X-ray planes), whether the injury is a finger fracture or another type of injury.

In rare cases, even an X-ray cannot clearly distinguish between a finger contusion and a finger fracture. In these specific cases, a computed tomography (CT) scan is necessary.

X-ray of a broken little finger on the left hand following a complicated fracture @ Adrian /AdobeStock

For many people, everyday life is impossible without using their fingers. However, there is also a high risk of damaging these delicate bones.

Our hands are our first line of defense against falls and hazards. As a result, 50 percent of finger fractures occur at work, with manual laborers being particularly at risk.

The following high-risk situations should be noted:

• Work
• Household
• Sports
• Traffic
• Leisure/Hobbies

There are many causes of finger fractures. External mechanical forces play a major role. A broken finger can result from dislocated finger joints. 

Broken fingers are common, for example, in sports injuries. In ball sports, there is a risk of breaking a finger when the ball strikes it. A collision with an opposing player can also result in a broken finger.

In addition, falling onto your hand can result in a broken finger. This is especially true if the finger is extended to the side or backward during the fall.

There are also many potential hazards in the home. Doors are particularly dangerous for children, as they often fail to notice them swinging open. This frequently leads to bruises and similar injuries. But boxes, trash can lids, and toilet seats are also sturdy enough to break a small bone.

Drivers are particularly at risk of breaking their fingers in a car accident. Even collisions at low speeds can put significant stress on the bones. The position of the hand on the steering wheel is a key factor in whether a fracture occurs. Therefore, always grip the steering wheel with your entire hand.

As people age and their sense of balance declines, many older adults face an increased risk of falling. The inner ear changes with age, which can lead to dizziness. Falls often result in injuries to the hands and fingers.

Finger fractures are common in ball sports @ Christian Schwier /AdobeStock

A broken finger causes severe pain, swelling, and limited movement. In some cases, misalignment or deep wounds may also occur, extending down to the bone or into the joint.

Typically, when a finger fracture is suspected, doctors take an X-ray to confirm the diagnosis. With the help of an X-ray, the doctor can determine the type of fracture and decide on a treatment plan.

Since there are different types of bone fractures, an accurate diagnosis of the specific type of finger fracture is absolutely essential.

Can an X-ray show every type of finger fracture?

The bones in the fingers are small. Therefore, multiple X-rays are required. An X-ray of the healthy hand may also be necessary or helpful for comparison.

Computed tomography (CT) is generally used only for very complex fractures. A CT scan is more accurate than an X-ray. A significant drawback of this technology—one that should not be underestimated—is the significantly higher radiation exposure.

Magnetic resonance imaging (MRI) can also be useful for diagnosing broken bones. The advantage of this examination is that it involves no radiation exposure.

This imaging technique works without X-rays. Instead, it uses magnetic fields. This allows for the visualization of adjacent blood vessels and cartilaginous structures.

If there is no fracture, it may simply be a bruised finger. This can also be very painful. The bone is uninjured, and healing is generally much faster.

The goal of treating a simple finger fracture is to allow the bone to heal as quickly as possible. Once healed, the finger can move freely again. After the examination and X-ray, the doctor decides which treatment is right for the patient.

There are basically two ways to treat broken fingers:

• conservative therapy and
• surgical treatment

Conservative therapy involves the use of casts and splints. For simple fractures, it is sufficient to secure the broken finger to the adjacent finger with adhesive tape. This form of treatment is often used for simple fractures of the little finger.

In cases of complex fractures, malalignment, or displacement of the bone ends, surgical treatment may be necessary. This also applies to open fractures, where the skin is broken and the broken bone ends are exposed.

Doctors use wires, screws, or small metal plates to firmly connect the bone ends and stabilize them. This makes it highly unlikely that the broken finger will heal incorrectly with a misalignment.

What is the most common treatment?

Many broken fingers heal well with conservative treatment and result in satisfactory finger function. Doctors usually determine the type of treatment based on a standard X-ray. 

A slightly displaced fracture without significant joint damage is treated conservatively. However, further examination may be necessary to assess the soft tissues and joints—preferably an MRI. The goal of treatment is for the fracture to heal in its natural and anatomical position.

A broken finger heals completely and without complications with prompt medical treatment. Primary care physicians are responsible for this; in special cases, trauma surgeons or hand surgeons may be consulted. 

The duration of splint or cast wear depends primarily on the type of fracture:

A simple finger fracture heals in three to four weeks on average.

Multiple finger fractures involving the carpal bones or the forearm bones take longer, usually 6 to 10 weeks.

Open fractures with additional skin wounds, exposed bone fragments, and broken finger joints also take longer to heal.

Nevertheless, it’s important to be patient, even if it’s difficult. However, putting weight on the injury too soon or keeping it immobilized for too short a time can jeopardize the healing process. This can lead to malunion, resulting in a misaligned joint.

In rare cases, the bone may fail to heal and remain unstable. Medically, this is referred to as a pseudarthrosis, which literally means “false joint.” 

The unhealed bone fractures remain mobile and form a kind of joint that is undesirable. This requires surgery.

The exact prognosis for a finger fracture depends on:

• Type of fracture
• Which fingers are affected
• How many fingers are affected

With proper treatment and consistent immobilization, the prognosis is good. The hand will be fully functional again once the fracture has healed.

How can you tell if a finger is broken?

A sure sign of a broken finger is a visible misalignment, where the finger appears twisted or bent. In addition, severe pain occurs immediately, which intensifies with pressure or movement. Within a short time, swelling develops, often accompanied by a bruise that turns dark. Finger mobility is severely restricted, often making it impossible to make a fist. However, bruises or sprains can also cause similar symptoms, which is why only an X-ray can provide a definitive diagnosis.

How is a finger fracture treated?

The goal of treatment is to ensure proper healing of the bone without restricting movement. Simple, non-displaced fractures are usually treated conservatively. This involves immobilizing the finger with a splint or cast for three to four weeks. Another common method is the so-called tape splint or buddy taping, in which the injured finger is secured to the healthy adjacent finger to stabilize it while maintaining some mobility.

When is surgery necessary for a finger fracture?

Surgery is required in cases of unstable or displaced fractures that cannot be stabilized by simple realignment (repositioning) alone. Open fractures, in which the bone pierces the skin, or fractures affecting the joint surfaces, must also be treated surgically. In hand surgery, osteosynthesis techniques are used, in which the bone fragments are fixed with a Kirschner wire, tiny screws, or plates.

How long does it take for a broken finger to heal?

The healing time depends on the severity of the fracture. On average, it takes about three to four weeks for the bone to heal and fuse together stably. However, it can take several months for full strength and mobility to be restored. Immobilization for too long can lead to tendon adhesions, which is why physical therapy should be started early.

What first aid measures can be taken?

Immediately after the injury, follow the RICE principle: Rest, Ice, Compression, Elevation. Applying cold packs (not directly on the skin) helps reduce swelling and relieve pain. The finger should be rested and the hand held elevated to reduce blood flow to the injured tissue. Rings should be removed immediately, as the finger can swell rapidly.

What complications can occur?

Possible complications include permanent loss of range of motion or stiffness, especially if the joint was affected. If the fracture heals in a malposition, this can impair the hand’s grasping function (rotational deformity), causing the fingers to cross over each other when making a fist. Osteoarthritis in the finger joint or infection in the case of open fractures are also possible risks.

What is an extensor tendon avulsion fracture?

This is a specific type of finger fracture that often occurs at the distal phalanx (mallet finger). In this injury, the extensor tendon tears a piece of bone from the distal phalanx, usually caused by a blow to the fingertip while the finger is extended. The distal phalanx then hangs limply and can no longer be actively extended. This injury is often treated with a special splint (Stack splint) that keeps the distal phalanx hyperextended.

Why is physical therapy important after a finger fracture?

Fingers tend to stiffen very quickly. Even after a short period of immobilization, tendons can adhere to one another and the joint capsules can shrink. Therefore, professional physical therapy or occupational therapy is often crucial for restoring the hand’s fine motor skills and strength. Targeted exercises help improve the mobility of the finger joints and reduce swelling.