How to Treat a Broken Finger

Determining the Severity of the Injury

Check your finger for any bruising or swelling. Bruising and swelling will likely occur because you have broken tiny blood vessels in your finger. If you have fractured the fingertip, there will likely be purple blood visible underneath your nail and bruising on the pad of your finger. You may also feel a sharp pain when you touch the finger. This is a symptom of a broken finger. Some people can still move their finger even if it’s broken and may experience numbness or a dull pain. These could still be signs of a fractured or broken finger and require immediate medical attention. Watch out for numbness or tingling as well, since these can be symptoms of nerve damage caused by a broken bone.

Check for loss of capillary refill by pressing gently on the area. Capillary refill is the return of blood to the finger after pressure has been applied. You can test this by pressing gently on the tissue near the injury to make it turn pale. If the normal color doesn’t return in a few seconds, then blood isn’t flowing to the area normally. If you aren’t able to see a difference in your skin color when you press on it, try using your nail bed, instead. Gently press your fingernail, then watch how long it takes for it to turn pink again. Note that a loss of capillary refill may be caused by other injuries in addition to a broken bone in the finger.

Examine your finger for any exposed cuts or bones. You may see large open wounds or pieces of bone that have broken your skin and are sticking out. These are signs of a severe type of fracture known as a compound fracture. If you have these symptoms, seek immediate medical attention. You should also get immediate medical care if there is a lot of blood coming from an open wound on your finger.

Check if your finger looks deformed. If part of your finger is pointing in a different direction, the bone is probably broken or dislocated. A dislocated finger occurs when the bone has moved out of position and usually looks deformed at a joint, such as your knuckle. You should see a doctor if you have a dislocated finger. There are 3 bones in each of your fingers and they are all arranged in the same manner. The first bone is the proximal phalanx, the second bone is the middle phalanx, and the bone farthest from your hand is the distal phalanx. Because your thumb is the shortest finger, it does not have a middle phalanx. Your knuckles are joints formed by the bones of your fingers. Often, you break your finger at the knuckles or the joints.

Note if the pain and swelling goes down after a couple of hours. If your finger is not deformed or bruised and the pain and swelling eventually subside, you may have just sprained your finger. A sprain means you have stretched the ligaments, which are the bands of tissue that hold the bones in your finger together at the joint. If you think you have a sprained finger, avoid using the finger. Check to see if the pain and swelling gets better over the next day or two. If the pain and swelling does not go away, you should get medical treatment to confirm the finger is only sprained and not fractured or broken. A physical exam and X-rays will determine this.

Treating the Finger on the Way to the Doctor

Apply ice to the finger. Wrap the ice in a towel and apply it to the finger on your way to the emergency room. This will reduce swelling and bruising. Never apply ice directly to your skin. If you cannot get to the doctor right away, ice the finger for 15–20 minutes every 2 or 3 hours. Keep your finger elevated above your heart as you ice it. This allows gravity to help reduce the swelling and bleeding.

Make a splint. A splint will keep your finger elevated and hold it in place. Alternatively, place a layer of gauze between your broken finger and the finger next to it, then loosely tape them together on your way to the hospital.To make a temporary makeshift splint: Grab a thin item as long as your broken finger, such as a popsicle stick or a pen. Place it next to your broken finger or have a friend or family member help you hold it in place. Use medical tape to wrap the stick or pen and your finger together. Wrap it loosely—the tape should not squeeze or pinch your finger. If your finger is wrapped too tightly, this can cause additional swelling and cut off circulation to your injured digit.

Try to remove any rings or jewelry. If possible, slide off any rings on your finger before the finger swells. It will be much harder to remove the rings once your finger swells up and starts to feel painful.

Take acetaminophen (Tylenol) to treat the pain. If you’re in a lot of pain, take an acetaminophen-based medication, such as Tylenol or Paracetamol, to take the edge off. Don’t take any NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen, until you’ve seen the doctor and they tell you it’s safe to do so. Some studies show that NSAIDs can slow down the healing process if you have broken bones, so your doctor may recommend avoiding these kinds of medications if you have a fracture. However, further research is needed. Icing your finger will also help numb the pain and keep any swelling down.

Getting Medical Treatment

Receive a physical exam from your doctor. Your doctor will ask for your medical history and perform a visual exam on you to get more information about you and to see how the injury occurred. They will check for deformity, damage to your nerves or blood vessels, problems with the position of the finger (such as twisting or dislocation), and skin lacerations or injury.

Let your doctor do an X-ray of your finger. This will allow them to confirm whether there is a fracture of the bone in your finger. There are 2 types of fractures: simple and complex. The type of fracture you have will determine your treatment. Simple fractures are breaks or cracks in the bone that do not break through the skin. Complex fractures are breaks in which the bone sticks through the skin.

Allow your doctor to splint your finger if you have a simple fracture. A simple fracture is when the finger is stable and there are no open wounds or cuts on the skin of the broken finger. The symptoms will likely not get worse or cause complications with your ability to move your finger once it is healed. In some cases, your doctor may strap your broken finger to the finger next to it, known as “buddy taping.” The splint will hold your finger in position as it heals. Your doctor may also move the bone back into place, a procedure known as reduction. You will be given a local anesthetic to numb the area. Your doctor will then realign the bone.

Talk to your doctor about pain medication. Take over-the-counter pain medication to reduce swelling and pain, but check with your doctor about which medicines are right for you and how much you can take each day. Your doctor can also give you a prescription for pain medication to decrease the pain, depending on the severity of your injury. If you have an open wound on the finger, you may need antibiotics or a tetanus shot. This medicine will prevent any infection caused by bacteria entering the wound.

Consider surgery if the injury is complex or severe. If the fracture is severe, you may need surgery to stabilize the broken bone. Your doctor may recommend open reduction surgery. The surgeon will make a small cut on your finger so they can see the fracture and move the bone. In some cases, the surgeon may use small wires or plates and screws to keep the bone in place and allow it to heal properly. These pins will be removed later once your finger has healed.

Get a referral for an orthopedic surgeon or hand surgeon. If you have a compound fracture, bad break, nerve injury, joint damage, tendon or ligament damage, or vascular compromise (damage to the blood vessels in your hand), your doctor may refer you to an orthopedic surgeon (bone and joint specialist) or a hand surgeon. These specialists will then examine your injury and determine if your injury requires surgery.

Taking Care of the injury

Keep the splint clean, dry, and elevated. This will prevent infection, especially if you have open wounds or cuts on your finger. Keeping your finger elevated will also help to keep your finger in position and let it heal properly.

Do not use your finger or hand until your follow-up appointment. Use your non-injured hand for daily things like eating, bathing, and picking up objects. It's important you give your finger time to heal without any movement or disturbance of the splint. Your follow-up appointment with a doctor or hand specialist should be about one week after your initial treatment. At the follow-up appointment, the physician will check that the bone fragments are still aligned and healing properly. For most fractures, you will need up to 6 weeks of rest before you can return to sporting activity or work.

Start moving your finger once it is out of the splint. As soon as your doctor confirms your finger has healed and it is out of the splint, it's important to move it around. If you keep it splinted for too long or immobile after it is out of the splint, the joint will stiffen and your finger will become harder to move and use.

See a physiotherapist if your injury is severe. The physiotherapist can give you advice on how to regain normal movement in your finger. They may also give you gentle hand exercises you can do to keep your finger moving and to ensure it regains its full mobility.