Broken hand: symptoms, treatment and how long it takes to heal

The hand contains many small bones: the long metacarpals in the palm, the finger and thumb bones, and the small bones of the wrist. Most "broken hand" injuries involve the metacarpals. Cambridge University Hospitals describes a metacarpal fracture as breaking one of the long bones in the palm of the hand, and says the location of the break depends on how the injury happened. A common example is the fracture at the knuckle at the base of the little finger, which Hull University Teaching Hospitals calls a fracture of the 5th metacarpal.

South Tees Hospitals says a metacarpal fracture can happen in a variety of ways, including a fall on an outstretched hand, a crushing injury or hitting an object with a clenched fist. St George's University Hospitals adds that a fracture may be a simple break across a bone or the bone may break into many fragments, and that it can be part of a more complex injury involving a dislocated joint or soft-tissue damage such as tendon cuts.

South Tees says there is usually immediate pain and swelling in the hand, and you may see that the hand is deformed. It is common to see a bump over the back of the hand where the fracture is. Cambridge adds that swelling and bruising at the fracture site is normal. Hull notes your knuckle may look a little different after the injury and that you may notice some shortening of the little finger.

For fingers and thumbs, the NHS says a break is likely to be painful, swollen, bruised and difficult to move, and may also change colour or feel numb. For the wrist and forearm, the NHS lists similar signs and adds that the limb may change shape and look bent or twisted.

The NHS says that for a broken finger or thumb you should go to A&E if the finger or thumb points at an odd angle, looks blue or feels numb, is cut so that you can see bone, or has bone poking out. It says to get help from NHS 111 if the injured finger or thumb is painful, swollen and bruised, or stiff or difficult to move. Do not drive to A&E; ask someone to drive you or call 999.

For a broken wrist, the NHS says to go to A&E or call 999 if the arm or wrist is numb or tingling, there is a bad cut bleeding heavily, a bone is sticking out of the skin, or the limb has changed colour, shape or is at an odd angle. St George's emphasises that an X-ray is essential to find out whether you have a fracture, and recommends attending your local A&E department for review and onward referral to a hand unit if needed.

The NHS suggests for a broken finger or thumb that you try not to move it (it may help to tape it to the finger next to it), lift your hand up to reduce swelling, apply an ice pack wrapped in a tea towel for 15 to 20 minutes every 2 to 3 hours, cover any cut with a clean dressing, take paracetamol and remove rings from the affected hand. Cambridge advises ice for 20 minutes three to four times a day and not wearing rings on the injured hand until it has healed.

Treatment depends on which bone is broken and whether the pieces are in a good position. Most of the NHS trust leaflets describe protecting the break and keeping the rest of the hand moving. South Tees says neck and shaft metacarpal fractures can be protected by strapping the fractured finger to its neighbour (buddy strapping), needed for three weeks from the day of injury, with the hand used only for light tasks. It says base and shaft fractures occasionally need a cast, usually for three weeks, with the fingers free to allow early movement.

For a minor, undisplaced 5th metacarpal fracture, Hull describes neighbour strapping for 3 weeks, possibly with a wrist splint for the same time, and advises regular simple pain relief. The NHS says for a finger or thumb a doctor or nurse might straighten it after a local anaesthetic injection, put it in a splint or cast or strap it to another finger, and give a tetanus injection or antibiotics if there is a cut. Surgery may be needed for complicated breaks, for example if the bone is broken in lots of places or nerves are damaged.

South Tees says swelling is part of healing, but too much causes pain and stiffness, so keep the hand raised at the level of your chest rather than resting by your side, and use a cold compress for 10 minutes three to four times a day in the first few days. It can take many months for swelling to settle fully.

Moving the fingers matters. South Tees explains that tendons run close to the break, and if you do not move your fingers the tendons can stick to the healing bone and limit movement or grip. It describes exercises done every one to two hours, 5 to 10 repetitions each, such as bending the fingers forward at the knuckles, hooking them, making a full fist and pulling them into a hooked position. Hull recommends early exercises four times daily, and says complete rest is not advisable.

St George's says hand therapy may involve splinting to protect the fracture from knocks and bumps and exercises to prevent stiffness; your therapist adjusts treatment to the fracture.

The NHS says a broken finger or thumb usually heals within 6 to 8 weeks but it can take longer, and it may be 3 to 4 months before full strength returns. For a broken arm or wrist it says recovery usually takes around 6 to 12 weeks, longer if severely damaged.

South Tees says that even after strapping is removed, the bone will not be strong enough for heavy work or non-contact sports until at least six weeks, and that contact sports, particularly boxing, should be avoided until at least 12 weeks after injury. Cambridge advises avoiding contact sports for six weeks. Hull says throwing, catching, gripping or punching activities should be avoided for 6 weeks until the fracture is fully healed, then built up gradually. If you return too soon to demanding activities you may worsen the injury.

Hull advises that you will not be insured to drive while your fingers are strapped or a splint is on, and that it is always good to check with your insurer. It says it should be safe to return to driving when you are no longer using the strapping or splint, can comfortably grip the steering wheel, move the gear stick, pull up the handbrake, activate the indicators and perform an emergency stop.

Hull recommends using the hand normally for everyday tasks such as washing, dressing and eating while in strapping. South Tees says the hand should only be used for light tasks during the strapping period. Cambridge says not to grip or lift anything heavy until the end of the strapping period, and to keep strapping on at all times, even at night.

Hull notes that smoking delays healing and should be avoided; the NHS advises seeing a GP if you are worried the break is not healing properly, pain and swelling have not started to ease after a few days, or it hurts to use the finger or thumb once the cast or strapping is off.

The sources used here describe adult hand fractures. For children, the same NHS advice applies: get medical advice as soon as possible if you think a bone is broken, because an X-ray is needed to confirm a fracture. For adults over 50 who break an arm or wrist, the NHS says a fracture liaison service can help prevent further broken bones and keep bones healthy; ask your GP surgery whether one exists in your area.

In the NHS, a suspected broken hand is assessed at A&E or a minor injuries unit with an X-ray, and many people are then followed up through a fracture clinic (sometimes a virtual fracture clinic, as in the Hull leaflet) and hand therapy. Complex injuries are referred to a specialist hand unit. Some people choose private orthopaedic or hand-surgery care for faster access; the principles of protection, early movement and graded return to activity are the same.