Elbow, Wrist & Hand

What It Is

A broken hand (fracture) is quite common. Common causes include falls, sports injuries, and hitting an object with a clenched fist; crush injuries and car accidents can also cause it (North Tees and Hartlepool NHS Foundation Trust, 2026; AAOS, n.d.). How serious the break is varies, but in many cases a hand fracture heals well without surgery (AAOS, n.d.). Fractures can range from a small crack in the bone to a break where the bone comes through the skin (an open fracture). Treatment depends on how severe the injury is and exactly where the break is. A more serious fracture, or one where the pieces do not line up properly, may need surgery to insert wires, screws, pins or plates to hold the bone in the right position while it heals (AAOS, n.d.).

For the hand to fracture, a significant force has to be applied to it. Hitting or punching a wall can cause it, as can other blunt trauma to the hand, sport, or car accidents where the hand hits the steering wheel.

Metacarpal Bone Fracture Anatomy

The metacarpal bones are the five long bones in the palm of the hand. They connect the fingers to the hand and wrist (AAOS, n.d.). They are labelled the 1st to 5th metacarpals, with the first metacarpal leading to the thumb and the 5th metacarpal leading to the little finger. The metacarpals lie between the carpal (wrist) bones and the phalanges (finger bones).

A metacarpal can break at different places along its length, from the head (near the knuckle) and neck, through the shaft (the middle), to the base (North Tees and Hartlepool NHS Foundation Trust, 2026). The most common hand fracture is a break of the fifth metacarpal, the bone that supports the little finger, near the knuckle. This is often called a "boxer's fracture" because it is usually caused by punching a hard object with a closed fist (AAOS, n.d.).

Most people have pain, swelling, bruising and loss of movement. The knuckle may look sunken or change shape, which is usually permanent. You may also notice a bump over the back of the hand where the bone is healing; this tends to get smaller over several months (North Tees and Hartlepool NHS Foundation Trust, 2026; AAOS, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How a Metacarpal Bone Fracture is Treated

Your treatment will be decided by the hospital or fracture clinic, and you should follow their instructions.

1. Pain Relief

Ask your pharmacist or doctor which pain relief is suitable for you.

2. Therapy

I can support the exercises your fracture clinic or hand therapist gives you, with hands-on work and exercise to ease stiffness and swelling and rebuild your grip, once your team says it's okay. See the My Approach tab for how I work.

It is important to start moving your fingers as soon as your hand therapist or fracture clinic advises, which for many metacarpal fractures is straight away, even if it is uncomfortable. This helps prevent stiffness and reduce swelling, and stops the tendons that bend and straighten your fingers from sticking to the healing bone (North Tees and Hartlepool NHS Foundation Trust, 2026). After a cast or splint, your hand and fingers may be stiff. A doctor or an occupational, physical or hand therapist can give you specific exercises to reduce stiffness and improve strength and function (AAOS, n.d.).

Treatments your doctor or fracture clinic may use

Options outside my scope

Buddy strapping or a soft splint: many fractures of the head, neck and shaft of the metacarpal are treated by strapping the injured finger to the one next to it, or with a soft splint. This protects the healing bone while still allowing early movement (North Tees and Hartlepool NHS Foundation Trust, 2026).
Cast: some fractures need a cast, which may reach from the fingers almost to the elbow (AAOS, n.d.; North Tees and Hartlepool NHS Foundation Trust, 2026).
Closed reduction: if the bone is out of position, a doctor may gently move it back into place without an operation (AAOS, n.d.).
Surgery: some fractures, including most open fractures, need an operation to realign the bone and hold it with wires, screws, pins or plates (AAOS, n.d.).

How I can help (see the My Approach tab)

Easing the neck, shoulder and arm while your hand is protected
Showing you how to buddy strap your fingers, if your clinic has advised it
Hands-on work and exercises for stiffness, swelling and grip, once your team allows

Tips

Crushing injuries, such as those from a car accident, might need surgery to repair them (AAOS, n.d.).
Combat sports and contact sports can easily cause a hand fracture if enough force is involved. After a metacarpal fracture, contact sports, particularly boxing, are usually avoided until about 12 weeks after the injury; check with your fracture clinic before returning (North Tees and Hartlepool NHS Foundation Trust, 2026).
If you have a cast or splint, never try to remove or alter it yourself. If it feels too tight, contact the hospital or fracture clinic straight away. If your fingers become numb or turn blue, call 911 or go to the emergency room (NHS, 2025).
Your fingers and wrist will likely be stiff once the cast or strapping comes off, and I can help at this point (see the My Approach tab).

Treatment

My Approach

After a metacarpal fracture, the bone needs protecting while it heals, but fingers kept still get stiff and swollen, and tendons can stick to the healing bone. Your fracture clinic decides how your hand is protected and which movements you can do. I work inside those limits, and if your fracture was treated with surgery or stops you doing your normal daily activities, I need your team's okay before any hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

While It's Protected

Easing the neck, shoulder and forearm, and the other arm, which takes over
Gentle lymphatic drainage above the splint or cast, with your hand raised
Coaching the finger exercises your clinic or hand therapist has given you
If you've been told to buddy strap your fingers, I'll show you how to do it yourself

Once Your Team Allows More

Warm applications and gentle hands-on work for the hand and forearm, with no heat over metal implants, and scar work once any wound has healed
Exercises to bend and straighten the fingers, make a full fist and move the wrist
Gentle joint mobilisation only once your team confirms the bone has healed
Grip strength with putty or a soft ball, building to everyday tasks, gym work and, when your clinic agrees, contact sport

If your cast or splint feels too tight, contact your fracture clinic straight away. If your fingers go numb or turn blue, call 911 or go to the emergency room.

What to Expect

Typical Course

Typical course: While your hand is protected, visits are usually short and about weekly; once you can use it more, most people come once or twice a week, then less often as they manage on their own. Recovery follows your fracture clinic's plan, and contact sports, especially boxing, usually wait until about 12 weeks after the injury.

What I Focus On

Working Within Your Team's Limits

Compensation Relief

Swelling Control

Finger & Scar Mobility

Grip Strength

Please read

When to See a Doctor First

When to Get Emergency Help

Get any suspected broken hand checked by a doctor. Call 911 or go to the emergency room at your nearest hospital if, after a hand injury, you can see bone through a cut or bone is poking out of the skin, a finger is pointing at an odd angle, or your fingers look blue or feel numb (NHS, 2025; AAOS, n.d.).

Sources

References

North Tees and Hartlepool NHS Foundation Trust (2026) Hand therapy - metacarpal fractures. Available at: https://www.nth.nhs.uk/resources/hand-therapy-metacarpal-fractures/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (n.d.) Hand fractures. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/hand-fractures/ (Accessed: 7 October 2026).
NHS (2025) Broken finger or thumb. Available at: https://www.nhs.uk/conditions/broken-finger/ (Accessed: 8 October 2026).

Massage therapy · Kitchener–WaterlooMetacarpal Bone Fracture

What It Is

Metacarpal Bone Fracture Anatomy

Self-Care & Treatment

How a Metacarpal Bone Fracture is Treated

1. Pain Relief

2. Therapy

Treatments your doctor or fracture clinic may use

Tips

My Approach

While It's Protected

Once Your Team Allows More

Typical Course

When to See a Doctor First

When to Get Emergency Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooMetacarpal Bone Fracture

What It Is

Metacarpal Bone Fracture Anatomy

Self-Care & Treatment

How a Metacarpal Bone Fracture is Treated

1. Pain Relief

2. Therapy

Treatments your doctor or fracture clinic may use

Tips

My Approach

While It's Protected

Once Your Team Allows More

Typical Course

When to See a Doctor First

When to Get Emergency Help

References

Related Conditions

Bennett's Fracture

Boutonniere Deformity of the Finger

Carpal Bone Fracture

Colles' Fracture

Book a session