Treatment of fractures of the metacarpals and phalanges using non-operative and operative techniques.

What is involved?

Hand fractures are common injuries that can affect any of the five metacarpals or the bones of the fingers (phalanges). The right treatment depends on the location and pattern of the fracture, how stable it is, whether it is angulated or rotated, whether the joint is involved, and what the patient's hand function requirements are.

Many hand fractures can be managed non-operatively with splinting or buddy strapping and hand therapy. Others — particularly those that are unstable, angulated, rotated, intra-articular, or open — benefit from surgical fixation.

Surgical options

  • Closed reduction and percutaneous K-wires — for many simple fracture patterns
  • Open reduction and internal fixation with plates and/or screws — for complex or intra-articular fractures
  • Intramedullary screw fixation — in selected metacarpal fractures
  • External fixation — in selected high-energy injuries

Recovery

Early mobilisation, where the injury allows, gives the best outcomes for hand function. Splinting, hand therapy and graded return to activity are tailored to the injury. Most fractures heal in 4–6 weeks, though full strength and range of motion may take longer.

Related: See our scar management guide for the post-operative healing timeline, the daily silicone-and-massage protocol, and when to be concerned about a scar.

All surgical procedures carry potential risks and complications, which will be discussed in detail at your consultation.

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Hand injury?

For acute injuries, present to your nearest emergency department. For elective hand surgery referrals see below.

For Referrers