Bony injuries of the hand are common reasons for attending the emergency department. They can range from simple injuries requiring short term splinting or activity modification, to life changing events requiring multiple operations.
Hand fractures are caused by sport, workplace injuries, motor vehicle accidents, and simple misadventure.
Hand fractures cause pain, swelling and loss of function, sometimes there is an obvious deformity as a result of fracture displacement.
Most hand fractures can be assessed by plain x-ray but more complex or subtle injuries may need further assessment by CT or MRI scans.
The diagnosis of many hand injuries is straightforward based on the initial emergency department imaging as well as history and examination. However, there are some injuries that are classically missed and early accurate diagnosis can make a big difference to the outcome.