What it is
This page covers common hand injuries seen in clinics: metacarpal fractures, including boxer’s fracture of the fifth metacarpal, tuft fractures of the fingertip, and volar plate injuries at the proximal interphalangeal joint. These injuries result from direct blows, crushing, or forced bending and lead to pain, swelling, and reduced mobility.
Care focuses on protection and alignment first, then early motion to prevent stiffness, followed by progressive strength and task practice.
What happens when it occurs
Bone or ligament structures fail under force. Stable patterns are treated with splints or buddy strapping. Displaced or unstable patterns may need reduction or fixation. Early safe motion prevents long-term stiffness.
Common causes and risk factors
- Punching incidents for boxer’s fractures
- Crush from doors or tools for tuft fractures
- Hyperextension injuries in ball sports for volar plate sprains
Who is most affected
Adolescents and adults involved in sports, manual labour, and DIY activities.
Typical symptoms
- Pain, swelling, and reduced motion
- Bruising and tenderness over the injured area
- Deformity or finger drift in displaced injuries
When to seek care
Immediately after injury, for imaging and planning. Open wounds, numbness, or deformity require urgent review.
How we diagnose
History and examination, X-rays in several views, and neurovascular checks. CT is used for complex patterns.
Management
- Protective splints or casts and wound care where needed
- Early safe range and tendon glides to prevent stiffness
- Strength and dexterity work as healing allows
- Surgical reduction and fixation for displaced or unstable injuries
Rehabilitation milestones
Phase 1 weeks 0 to 2: protection, swelling control, gentle motion within limits.
Phase 2 weeks 2 to 6: increase range, light strength, scar care.
Phase 3 weeks 6 to 12: functional strength, grip and pinch drills, task practice.
Readiness to progress
- Pain and swelling trend down
- Stable alignment and healing as advised
- Dexterity and strength targets met for tasks
Prevention
- Protect hands with good technique in contact and ball sports
- Use safe tool handling and guards for doors and machinery
- Maintain general hand and forearm strength
Australia snapshot
- Common in contact sports, workplace incidents, and home projects
- Public and private services provide imaging, splinting, and hand therapy
- Most return to work within weeks with a staged plan
Latest insights
The first decision is stability and alignment. The second is early motion to prevent stiffness.
Hand therapy after immobilisation shortens the path back to dexterity.
