broken hand

[Dan25000]

ok there was just a post up about boxers fractures...well i got a boxers fracture a little while ago, i broke 2 bones. the doctor "fixed" it, does anyone know if it is normal for my hand to have two collapsed knuckles, a huge lump over one of the broken bones, and half of the hand raised higher than the other half? i am going to get a second opinion but i was just wondering what you guys think before i get to the other doctor. thanks

Dan

[Thai Bri]

No, thats perfectly normal mate. Why, my own hand has 18 fingers, 3 toes and a dog growing out of it.

Get a second opinion asap mate. Or risk permanent damage. Where did you find the doctor who "fixed" it? In a box of frogs?

[fozzy40]

Dan,

I've worked in hand surgery for about 3 years so I feel confident enough to give an answer.

There are a couple of questions I would need to know:

-How soon after you injured your hand did you seek medical attention?
-If you went to the ER, how soon after did you follow up with an orthopedist?
-Was it an open or closed fracture? Basically, was either of your metacarpals sticking out of through the skin?
-How long ago was the break?
-Was a plate or pins used to reduce the fracture?
-Were you casted? If so, how long were you casted?
-Did you regain your range of motion?

These are some basic questions that any hand surgeon would ask so please be candid. Hope I can help you.

Fred

[Dan25000]

Right after I broke my hand I went to the emergency room where they put me in a cast. The next day I went to an orthopedist that was recomended by the hospital. It was a closed fracture, the bones were not sticking out of the skin. The break was the beginning of may or the end of april i think, I got my cast off 3 weeks ago. He had to do surgery to put the bones back in place, but he did not open the skin. There were no pins put in place in my hand. I had the cast on for about 5 weeks, after 3 weeks I noticed that I had a huge lump on my hand. We went to see the doctor he said a mixture of things. #1 it is fine, #2 the bone is healing it self, (where he compared it to welding of metal) #3 "everyone heals differently, god wants it this way. some people might get a huge scar from a paper cut and others nothing from a knife cut, this is the way god wants it" after the 3rd reason i was getting alittle agitated. Wes I can basically function the same way I could before with my hand. I do have some discomfort when I grip different things. An example is the stearing wheel. I can't use my right hand when I drive. Right now I can deal with the pain, but I am worried that later in life it might turn to artheritus (might not be spelled right) . i brought up the artheritus factor when i was talking to the doctor and he gave me the same answer. "god works in different ways so you might get it or you might not." At the moment I just don't want a hand that looks deformed though.

[fozzy40]

Hmmm...not too sure about the God references but here is my opinion so please take it with a grain of salt.

Closed metacarpal fractures generally do not have plates or pins put in for the simple fact that functionality of the hand can be severely compromised. So it kind of comes down to two different outcomes:

a hand that looks "normal" but doesn't move very well vs. a functional hand with a small "lump" on the back side of the hand

Docs and patients will always choose the latter.

With every metacarpal fracture there will be SOME amount of angulation or "lumping" of the metacarpals. These lumps are most prominent when you first come out of the cast but bones are continually remodeling themselves on a daily basis. So, the lump will be LESS prominent over time but you will probably always feel it a little bit.

My boss (a well-respected hand surgeon) will cast these types of fractures for 4 weeks and then start hand therapy on the fingers and wrist at this point. The bones are safe to move at 4 weeks but have not completely healed until about week 6. Hand therapy is crucial to the outcome of the hand and failure to do so may result in loss of range of motion and/or pain.

Concerning the arthritis, I doubt that you will have any difficulties with arthritis of the hand down the road. If the fracture was into a joint space then the doctor probably would have operated on you to realign the fracture. Fractures into the joint are usually the ones that become problematic (i.e. arthritis) in the long run vs. non-joint related fractures (i.e. boxer's fractures.)

Now I have some questions for you:
1) What causes you to have pain in your hand?
2) Did you have hand therapy?
3) What exactly do you want out of a second opinion?

I hope that this was helpful and I look forward to your response.

Fred

[Dan25000]

well, i'm not sure what causes me to have pain in my hand, but basically when i grip certain things (ie. the stearing wheel of the car) i have a sharp pain over the bone of the ring finger...the metacarpal. not the finger itself but the bone in the hand. also when i flex my fingers in different ways, pain is also produced over the broken bones.
I never went to therapy, he never told me to go and/or never gave the option of therapy.
Out of my second opinion, i want to make sure that my hand is alligned right, and if what i'm experiencing is normal with a broken hand. the one thing i don't understand is, if my hand is normal then why do i not see any other people with hands that look similar to mine? the few people that i have met that broke their hand in the same places have normal looking hands, and can function with perfect ease.

[fozzy40]

Sorry that you are having such difficulties. My only criticism is that therapy is a crucial part to any healing process. However, different physicians have different styles of practice. My training has always emphasized the importance of starting motion as soon as the cast comes off.

I think that it's wise to get a second opinion at this point. Make sure to get an opinion with a hand surgeon. You should inquire and make sure that the doc has had a one year fellowship in hand surgery. These guys have had an extra year of hand training.

Good Luck.

Fred

[Dan25000]

Thanks Fred for all your help. I'll post the results of what the doctor says. I have an appointment tomorrow with the new doctor. Thanks again!

Dan