Crush injuries and boxer's fracture are common hand injuries that may cause a knuckle to break. Here, we will find out more about the symptoms of broken knuckles along with the treatment options.
A joint refers to the place where two or more bones meet. While bones are the most vital anatomical structures of the human skeletal system, it is the collective work of the muscles, ligaments, cartilage and tendons that facilitates and restores normal range of motion of a joint.
Out of the various joints of the human body, knuckles are the joints, that are formed by the bones or phalanges of the fingers. Traumatic hand or finger injuries could cause knuckles to break. Given here is some information on the type of finger injuries that may cause damage to the knuckles.
Causes and Symptoms
There are three bones in each finger, and these are referred to as the proximal phalanx, middle phalanx and the distal phalanx. The largest knuckle joint, which is also referred to as the metacarpophalangeal joint, is the joint which forms at the base of the fingers, where the phalanges of the fingers connect to the metacarpal bones.
This joint helps us to bend or straighten the fingers. People who indulge in boxing or play contact sports that involve punching are certainly more susceptible to such injuries. The term boxer’s fracture is often used with reference to such injuries. Punching on a very hard surface could cause a knuckle to develop cracks.
Besides the metacarpophalangeal joint, the proximal interphalangeal joint as well as the distal interphalangeal joint could also get dislocated or fractured. These joints may get fractured if the affected finger is struck by a moving object such as a ball.
If the finger gets crushed under a heavy object, or is bent forward or backward beyond tolerable limits, there could be major damage to the bones. The severity of symptoms would depend on the extent of damage. If one experiences signs like deformed or swollen knuckles, pain, bruising, inflammation and reduced range of motion, one must consult a doctor soon.
Diagnosis and Treatment
A physical examination certainly helps doctors ascertain the effect of the injury on the range of motion of the joint. However, a physical examination alone would not suffice. An X-ray examination of affected finger would have to be conducted in order to ascertain whether the bones that make up the interphalangeal joint have broken or have been dislocated.
Once these tests have been performed, and the doctors are aware of the extent of damage, they will decide the most suitable treatment. Most of the doctors incorporate the RICE (Rest, Ice, Compression and Elevation) principle as a part of the treatment. One must take rest and refrain from indulging in any activity that may put strain on the knuckles.
Anti-inflammatory drugs and painkillers will also be prescribed to alleviate knuckle pain and stiffness. Most of the time, doctors immobilize the finger with the affected knuckle, by placing a wrap around the affected finger and the adjoining finger. This will immobilize the bones and speed up the healing process.
In severe cases, where there has been significant damage to the bones, surgery may be required. During the surgery, K-wires or interosseous wires may be placed around the bones to realign them. While K-wires are removed once the knuckle has healed completely, interosseous wires can even be left inside.
External fixation devices or a metal bar and pins may be used to hold the displaced bone fragments in place, until it heals completely. As is the case with any surgical procedure, complications may arise. There is always the risk of infection. This is tackled with the help of antibiotics.
There may be stiffness around the knuckle, which is why, doctors suggest the patient to go for physiotherapy sessions. Performing certain exercises can certainly help in recovering the normal range of motion.
While children may recover from such an injury within a month, adults may take six to eight weeks to recover. Even a slight injury can lead to a fracture in case of people who have been diagnosed with degenerative joint conditions. Such people must, therefore, be very careful.
While drugs can help in alleviating the symptoms, self-care measures must be followed in order to speed up the recovery process. Immobilization of the joint is bound to cause stiffness, but performing exercises can certainly help in restoring the normal range of motion.