Following an X-ray to determine what kind of fracture you have, the Hand surgeon will carefully decide what method to use to reset the bone. Easy to set fractures require a closed reduction technique with or without using pins or wires. Complex fractures may require surgery known as open reduction and internal fixation (ORIF) using screws, metal plates and tension band wires.
Once set, the hand is immobilised for a short while in a cast which is later reduced to a splint by your Hand therapist. Specific exercises several times a day are prescribed by your therapist to limit stiffness and swelling in the surrounding joints and in some cases even the affected bones.
The treatment you receive from your Hand therapist will be instrumental in gaining maximum movement and strength in the fingers. Without Hand therapy and post-repair exercises, even the most skilled surgical repair could fail.
The hand by nature moves as one unit, so providing stability to part of it to allow a broken bone to heal is difficult.
The skilled Hand therapist will, however, be able to calculate a fine balance between immobilising the bone to protect the fracture so it can heal undisturbed and moving it as soon as possible to make sure the soft tissue structures beside it stay strong and mobile. In certain circumstances the fractured bone and nearby joints may need to be gently moved during the healing stages with supervision from your Hand therapist.
Other hand structures such as
digital finger nerves may have been injured at the same time as the fracture so your Hand therapist will design a treatment programme that treats the hand as a whole and not merely the isolated fractured bone.
By far the biggest problems that prevent healing are swelling, stiffness, rotation of the fracture, non-union of the bone and a patient who does not do their exercises.
Once the fracture has been stabilised the first problem needing treatment will be swelling. Swollen fingers or hands following a fracture or surgery can make it very uncomfortable to wear a cast or perform any movements safe to perform.
A thermoplastic splint made by a Hand therapist however, will be light weight, re-mouldable and adjustable to allow for initial swelling to reduce. Overall you'll find that customised hand splints are more comfortable to wear for several weeks.
In some cases, early active motion (EAM) exercises are prescribed by your Hand therapist to target specific joints and muscles. This is to keep them free from any stiffness and adhesion to the healing areas. It is important to perform these several times every day if you have been told to do so. NEVER feel tempted to perform a movement you have not been told to do.
If you have had ORIF you will have a surgical scar and this also needs specific treatment to
massage the scar to keep it flat and soft.
Hand Kinetics know the importance of effective rehabilitation to prevent lingering pain and loss of movement following a hand fracture. We use
medically accurate measurement of movement and strength and can liaise with your hospital team to keep them up to date with your progress when needed.
We appreciate the difficulties patients have attending hospital clinics every week as they may not be insured to drive while wearing a splint. Treatment will require a friend or family member taking you for appointments in larger hospitals. Hand Kinetics have an out of hours clinic and flexible appointments which may help you.
Contact Hand Kinetics to discuss treatment options and how we can support your hospital team.
Please note:
If you have had arm or hand surgery please telephone to discuss this before attending. It is always helpful to bring any x-ray reports you may have if you recently attended hospital for your hand or arm condition.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
