When a fracture (broken bone) occurs in the hand, it can cause significant pain and dysfunction of the hand. Not all hand fractures require surgery. Some fractures can be treated by resting the area in a splint or cast. This is where the location and position of the fracture will heal without causing future problems for the hand. Healing progress is monitored by intermittent xrays.
If the broken bones are out of place or can easily slip out of place, then surgery may be necessary. When the fracture is involving a joint surface, even small amounts of malposition can cause problems. The first step is to put the fractured bone into the correct position or to reduce the fracture. If it has a good chance of holding the new position, this is all that is necessary and a splint will be applied to support and rest the area.
However sometimes after reducing the fracture into place, it can still slip out of place easily. Then it is necessary to hold or fix the fracture into place with metal supports (wires, pins, plates and screws). These may need to be removed later (pins) or may stay permanently in the hand (plates and screws). Again, healing progress is monitored by xrays.
Most fractures in the hand require four to six weeks of some degree of rest and support. After this initial healing period, activity is usually increased to prevent excessive stiffness of the hand. It usually takes about twelve weeks before solid healing has taken place enough to allow heavy manual work.