Advice After a Hand Fracture (Fifth Metacarpal)

Patient Information Leaflet

Introduction

You have a minor break near one of your knuckles (please see figure 1).

(Figure 1: Image demonstrating a hand with an arrow pointing to the fifth metacarpal area, where the break is in your hand)

We will usually provide you with a wrist splint (without thumb extension) and neighbour strapping to help the pain and allow early movement.

What should I do at home?

• Neighbour strapping & wrist splint: The neighbour strapping and wrist splint should be used for 2 to 3 weeks, mainly for comfort. After a maximum of 3 weeks, remove the strapping and splint completely.
• Early Function: You can actively use your hand for light daily tasks, if pain allows, starting from today.
• Normal Use: Once the splint is off, use your hand as normally as possible. This will not cause further damage.

Activity and Sports Restrictions

For six to eight weeks you should avoid all of the following:

• Heavy lifting (anything heavier than a full cup)
• Gripping
• Carrying
• Resistive activities (any activities that cause resistance in your hand muscles)

Note on School/Work: It is completely safe for your child to go to school or for you to return to light work activities while healing.

How long will it take to heal?

The break will start to heal within six weeks. However, it may take six to 12 weeks or longer before your hand returns to normal.

Hand strength is generally very good after this type of injury. As the bone heals, a permanent lump may form at the break site and the knuckle may not be as prominent. Your finger may be slightly shorter as a consequence of the injury.

While your injury is healing, you may still experience pain. Take painkillers such as paracetamol or ibuprofen, if you can take them (always read the label; do not exceed the recommended dose).

Splint care

Wear the splint day and night for the first three weeks. To make sure the splint does not get wet, it can be removed for short periods for personal care and to allow you to wash your hands.

Exercises

Do the exercises below four to five times a day:

1. Keeping fingers straight, bend from the knuckle (fig. 1a)
2. Bend the fingers down to reach the palm of your hand (fig. 1b)
3. Bend the top of your fingers (fig. 1c)
4. Curl your fingers into your palm (fig. 1d)

Repeat each exercise 10 times.

(Figures 1a, 1b, 1c, and 1d: Images demonstrating sequential hand and finger mobility exercises)

Follow-up & Open Access ED Clinic

You do not need to visit your GP for problems relating to this fracture. Instead, we provide open access directly to our Emergency Department clinic.

Parents, carers or patients themselves can self-refer back to the ED clinic, especially if they have pain or functional limitation persists beyond 4 weeks.

To book an open access review appointment, please call the clinical team during working hours at 01384 456111 (Ext. 3140).

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on (01384) 456111 and ask for the relevant department who issued this leaflet.

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Author: Dr Ali Al-Sharifi
Document No: DGH/PIL/01364   –   Version No: 04
Expiry date: Sep 2029   –   Review date: June 2029