A broken knuckle involves a fracture at the end of a metacarpal bone, the bones that link the wrist to knuckles. The injury often occurs when the top of the bone is exposed to a hard impact, such as punching a wall with a fist, and can cause symptoms including swelling, pain and restricted movement in the knuckles. Caring for the injury correctly can prevent further complications developing.
Any suspected broken knuckle should be seen by a doctor. First, an X-ray will be required in order to confirm whether the knuckle has been broken and second, the sooner a doctor can confirm a diagnosis and form a plan for recovery, the sooner the healing process can begin. Depending on the nature and severity of the injury, medical treatment could involve a plaster splint, bone manipulation through the skin or surgery involving the insertion of pins or wires to align and fix the broken knuckle.
If you can't see a doctor immediately, there are several ways to deal with the injury until you do see one. A temporary splint, made from an object such as a pen, can be strapped onto the affected finger to prevent further strain on the injury. The patient can also help to keep their injured hand immobilised by holding it with their other hand. A cold compress made from an ice-pack wrapped in a cloth can be an effective way to limit pain and swelling, while cleaning any broken skin as soon as possible can help to reduce the risk of infection.
Movement plays an important role in recovering from a broken knuckle. Immediately after the injury, the hand should be kept as still as possible in order to prevent further pain. However, it is essential move fingers gently throughout the day if the hand is in a plaster cast as this will help to boost circulation and limit inflammation around the injury. Hand exercises suggested by medical professionals can also help to reintroduce normal movement and prevent joints from seizing up after the knuckle has healed.
Coping with pain
Broken knuckles can cause pain through pressure placed on the nerve fibres within the bones and through the inflammation that occurs around the area of the injury. Painkillers such as paracetamol or ibuprofen can help to reduce the severity of the pain while the hand is healing, but should only be taken after reading the leaflet and instructions carefully.
Caring for a plaster splint
If a broken knuckle is treated with a plaster splint, it is essential to keep the splint dry, clean and in the correct position to help the knuckle heal correctly. A plaster splint should be kept as dry as possible in order for them to stay strong and effective. Keeping the splint clean is also important as it can prevent any broken skin from becoming infected.
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