Hand bone broken?

June 29, 2010 4:30 PM

I think I broke a bone in my hand. 5th metacarpal, the one that connects to the pinky. Looking for a bit of advice.

I punched something a bit too hard, is what caused it. Just being stupid. The knuckle seems displaced, which is what worries me, but what's weird is that it doesn't hurt much at all. Just a dull ache, like a bruise. I'm holding off on the ER since I'm off insurance at the moment (sigh), but my intuition is that if it were broken, I'd be in some serious pain. The last time I broke a finger I knew it -- the thing hurt like hell. One thought is that breaking a hand bone may not hurt because it's kind of supported by the meat and swelling in the way a finger wouldn't be. But I don't know.

ANYWAY: Anyone have any experience with these kinds of injuries? If it is broken and I don't go to the hospital am I asking for a lifetime of hand troubles? I know not to expect real medical advice, I'm just looking for a bit of anecdotal evidence and experiences from someone who might've had a similar injury while I sit here and fret about the whole thing.

Thanks!

posted by chasing to health & fitness (16 answers total)

You are definitely asking for a lifetime of troubles. It will cost you much more in the long run not to get it taken care of now. If you're near a teaching hospital they generally have low income programs that will make it relatively affordable.
posted by stoneweaver at 4:39 PM on June 29, 2010

A few fast diagnostic questions:

When you make a fist, assuming you can, do you notice any difference between your affected hand's knuckles and your other hand? Do they look substantially different from one another?

How painful, if at all, is typing?

Can you touch your pinky finger to your thumb without straining?

Is there any swelling?

How long has it been since you injured it?

Is the back of your hand over the bone tender when you poke it?

Is there any numbness or tingling?

You may have cracked the bone, rather than broken it completely. Cracks can be really tricky to deal with, especially in the hand. I've had a number of fractures and cracks in the metacarpals before, and they have all been different. Some have HURT like a bastard, others have been fairly painless, and I didn't realize I had cracked the bone until the bruising came up days later, or until a doctor asked me when I had cracked the bone looking at an x-ray (I get regular hand x-rays due to rheumatoid arthritis). The prime worries are damage to the tendons, damage to the bone ends, bones not being aligned correctly to knit, and infection. If you have ANY difficulty moving the finger, making a fist, or see any sign of an infection (redness, swelling, heat in the flesh) go to the ER or a doctor RIGHT away.


If it is fractured, you have what is known as a Boxer's fracture, which will help you google for symptoms.
posted by strixus at 4:42 PM on June 29, 2010

I broke a metacarpal before, and it didn't hurt that much at all (as I remember) but I also didn't feel real well either and it swelled up like a SOB, basicaly the actual injury was numb until much later (next day).

When I dislocated a knuckle (I think, never saw a doctor about that one), it didn't swell nearly as much and only hurt when I made a fist, but did that for almost two months and wound up being a lot worse of a bother than a cast.

The broken bone was over fifteen years ago, and I got it putting up Christmas lights for someone with deep pockets who was worried about me, but the hospital (big city trauma center, who were annoyed by my being there) and all the doctors visits wound up costing less than a thousand dollars total. Ymmv, but if it's swelling badly or even if it's not, I'd get it looked at PDQ. (The people who notice such, still notice that that hand is crooked, that's with a cast; I think it would have ended up mangled without one. The knuckle is just kind of big and gnarly, and the grip isn't as good as it once was.)
posted by Some1 at 4:48 PM on June 29, 2010

Years ago I had a roommate who punched a wall (over a girl). He didn't seem to be in much pain, but when feeling around the meaty part of his hand one of the bones was definitely not right. He went to the ER - he had broken a bone & needed a cast.
I'm of the mind that hands are very important and useful, & wouldn't hesitate to get to the doctor. Why risk it?
posted by ants at 4:51 PM on June 29, 2010

I broke the 4th metacarpal of my right hand last summer. I didn't think it was broken at the time but after a couple hours of watching it swell and poking at it a bit I decided I'd better deal with it.

I went to the urgent care clinic. They gave me an x-ray and a splint. They instructed me to have multiple follow up visits with another doctor, to get more x-rays, and said that I'd need a proper cast. I had one quick follow up in which I explained that I didn't want any treatment that wasn't absolutely necessary and they obliged. In the end I never got a cast or any more x-rays and I'm no worse for it. In fact, I could easily have applied the splint myself and saved all the money.

Having said all that, it was clear from my x-ray that I had a lucky break. There was no splintering, the break was oblique (broader healing surface), it didn't get into the knuckle area, and it was properly aligned.

You have no idea what your break looks like and there are a half dozen or more ways that a break can heal improperly without proper alignment or immobilization. My brief conversation with the doctor made clear to me that permanent damage from a simple break like this is not only possible but it is not at all uncommon. So, I'd at least get the preliminary visit to get it checked out.
posted by esome at 5:06 PM on June 29, 2010

Re strixus:

> When you make a fist, assuming you can, do you notice any difference between your affected hand's knuckles and your other hand? Do they look substantially different from one another?

Yes, the knuckle looks kind of flattened out.

> How painful, if at all, is typing?

Not very. The finger feels weak, though.

> Can you touch your pinky finger to your thumb without straining?

Yes.

> Is there any swelling?

Mild.

> How long has it been since you injured it?

~6hrs.

> Is the back of your hand over the bone tender when you poke it?

It's sore, but it doesn't feel much like anything special.

> Is there any numbness or tingling?

Now that you mention it, yeah, but very mild.

Thanks!
posted by chasing at 5:12 PM on June 29, 2010

I broke a finger when something slammed into my hand. I looked down and saw the bone without benefit of X-ray. It didn't hurt. (I was sure that it should, and so I was probably in shock, and got a ride to the hospital instead of driving myself.) And FWIW on top of that: I could move everything just fine and was sure that it wasn't broken, and tried to argue about X-rays. Turns out it was cracked clear through, substantial break.

I broke a toe once, too, and it was after hours. The on-call from the primary care doc wouldn't give me the permission my health insurance required to go to the ER (bastards, all of 'em). He said all they'd do was tape it to the next one over, that I could do that at home. 6 weeks later, when it hadn't improved at all, I found out that it wasn't a simple break and I *should*have had it fixed right at the beginning. And it was too late to do anything to help it heal correctly. It's a pretty minimal problem in a toe (arthritis, aches in weather changes, wider shoe)--but your hands, man, your hands, those're a lot more important.

So yeah, if you think there's something off about the bone, even if it doesn't seem to hurt, it's definitely worth getting things checked out.
posted by galadriel at 5:16 PM on June 29, 2010

Yeah, I've broken two finger bones and not known it until going to the doctor a couple of weeks later to find out why my bruise wasn't going away. One of the breaks resulted in several months of decreased finger movement, and I still feel achy when it rains. It's quite easy to break things without realizing it, and the long-term consequences can be annoying or worse. Is there a sliding-scale clinic or anything near you?
posted by Addlepated at 5:40 PM on June 29, 2010

Yeah, I'd consider going to an Urgent Care or calling a doctor for an opinion. It sounds like either a crack or a small fracture.
posted by strixus at 5:46 PM on June 29, 2010

I'm at the ER -- going to get this thug checked out. If it costs a bunch, that's life. Would rather not be perma-screwed-up. ;-)

Thanks for the info, everyone! After reading about boxer's fracture, that's my guess as to what's gone wrong... Dammit.
posted by chasing at 5:57 PM on June 29, 2010

I broke my 4th right punching something (I think my ex's car? idk) and didn't even realize it until it turned green a week or so later. It didn't hurt much more than the rest of my unbroken hand at the time. I finally went to the doctor about 5 weeks after it happened, and he said it was already healed on its own. I have no loss of movement/feeling in the hand, although my ring finger is a little wonkily angled now. Obvsly YMMV.
posted by elizardbits at 5:59 PM on June 29, 2010

Good luck, man! hope it heals up nice and straight for you.
posted by stoneweaver at 6:12 PM on June 29, 2010

I did this in h.s. after punching a kid in the forehead who kept questioning my sexual orientation (I know, juvenile). It'll heal up nicely if it's set properly, and shouldn't take long.

The embarrassing part is if you break a 5th metacarpal everyone automatically knows what you've done. :-)
posted by randomkeystrike at 7:22 PM on June 29, 2010

Yup. Broken. Glad I took everyone's advice...
posted by chasing at 9:20 PM on June 29, 2010

Glad you got it taken care of!
posted by galadriel at 9:41 PM on June 29, 2010

Generally boxer's fractures heal cleanly (provided they're cast). Ask me how I know. Glad you got it looked at, and good luck with the inevitable itching during the hot summer.
posted by workerant at 10:54 AM on June 30, 2010