When Can I Play Again: Finger Fracture

December 4, 2018 | hand, Treatment

Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Most finger fractures can be treated without surgery, in a cast or splint, with typical 3 to 6 week healing times
  • Some finger fractures are rotated, unstable, or extend to the joint surface. These will sometimes require surgery in order to ensure proper hand function.
  • Fractures treated surgically will also typically require 3 to 6 weeks recovery time, but in some special instances return to play after surgery can be as fast as 2 weeks

A broken finger (“finger fracture”) is a pretty common sports injury, often seen with direct impact to the tip of the finger or from a twisting injury. It’s easy to dismiss these as “minor” injuries, but all finger fractures need to be managed properly to allow for normal function to the hand. Mismanaged fractures can lead to significant issues with grip and hand function. Fortunately, proper management of finger fractures will typically allow return to sport in 3-6 weeks, depending on specific factors.

A broken bone in the hand typically becomes very painful, very quickly. Swelling and bruising often set in quickly too, frequently within minutes of the injury. These are telltale signs of a possible broken bone: significant pain, with rapid onset of swelling and bruising. If you’ve had an injury to the hand with these characteristics, I’d recommend you seek proper evaluation in an urgent care clinic or physician office.

The broken bone is diagnosed with an x-ray. The most important features on the x-ray are the location of the break, whether it is angled or rotated, and whether the ends of the bone are properly aligned.

If a bone is misaligned, it can often be realigned by the orthopedic specialist. X-rays are obtained before and after the realignment to confirm the proper positioning. If the positioning is normal and the doctor determines the break to be “stable”, it will typically be treated in a cast or splint. Adequate healing for non-contact sports may take place as early as 3 weeks. For contact sports you may need 6 weeks for full bone healing that will allow for impact.

Some fractures are rotated, or may be “unstable”. Your orthopedic specialist will be able to make this determination based on the x-rays. The problem with a rotated fracture is that if the finger heals in the rotated position it will affect proper grip. Rotation and angulation problems will sometimes require surgery, where the bone is properly aligned and then held in this position with internal screws or plates. Breaks extending into the joint surface may also require surgery. Surgery ensures that the alignment will be maintained during bone healing, and gives the best chance for normal hand function for these unstable fractures.

Healing and return to sport after surgery is similar to finger fractures treated without surgery, typically 3 to 6 weeks depending on the sport. Interestingly, for some high level athletes we can allow return to sport with protection (such as a cast) as early as 2 weeks after surgery. This is a complex decision requiring a thorough discussion with your surgeon.

Treatment from a hand therapist is often needed after surgery, and rarely needed for finger fractures treated without surgery.

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