Knuckles are bony prominence that you feel when you clench your fist. Knuckles are relatively strong and they do not break easily. But when present, broken knuckles can be an unpleasant experience for the patient. Pain, swelling and stiffness can affect his daily activities.
The hand is made up of finger bones and the bones present in palm. The bones of fingers are called phalanges while bones present in palm are called metacarpal bones. Knuckles are at the end portion of metacarpal bones. It is actually a metacarpo-phalangeal joint.
Knuckle fracture usually occurs due to a punch on hard object or a hard surface such as a wall.It is a common fracture among boxers. Immobilization of broken knuckle, ice fomentation, splinting, are some of the home measures if there is a hair line fracture. However, more invasive procedures such as surgery may be required when the knuckle is entirely broken.
Signs & Symptoms Of A Broken Knuckle
In most cases of broken knuckle, there is a history of injury. Usually a single knuckle bone gets broken after an injury. However, sometimes more than one knuckle bone can break, depending on the force applied while hitting. Here are following symptoms of broken knuckle:
- Sunken bony prominence: When you clench your fist, there will be a shallow depression instead of bony prominence if the knuckle is broken.
- Pain: Pain is the first symptom experienced by the patient after an injury to the knuckle. The area feels tender to touch.
- Inflammation: Within few minutes the area will become swollen. Due to swelling, it becomes difficult to move knuckle joint. The swelling can spread to nearby knuckles and fingers. The area becomes swollen due to accumulation of blood and extracellular fluid.
- Bruising: There may be bruising on the outer surface of the skin. Sometimes the skin over knuckle gets lacerated and blood oozes out from the wound.
- Numbness: The nerves near knuckles may get damaged resulting in numbness.
- The finger is unable to bend properly.
How Do You Treat Broken Knuckles?
If you suspect that your knuckle is broken, ensure that you visit your doctor. X-ray of knuckle helps to accurately diagnose broken knuckle. Following home measures and first aid treatment are useful till the time you consult him.
- Clean the wound: Clean the skin area around the affected knuckle if there is a cut or abrasion. You can use soap water or an antiseptic solution to clean the area. It helps to prevent infection in the broken bone.
- Apply ice pack on broken knuckle. Ice fomentation is beneficial in reducing swelling as well as pain.
- Keep your hand elevated above the level of heart.
- Strap the affected finger with the adjacent finger. Keeping the finger straight and strapped helps to restrict the movement of knuckle.
- Instead of strapping you can use a splint meant to keep the finger straight.
- Anti inflammatory and analgesics for relieving pain and swelling.
Sometimes even after taking proper treatment measures there is possibility of mal union or delayed union of the broken knuckle bone. Depending on the severity, the doctor may recommend other medical measures to fix the bone correctly.
Different options available are K-wire fixation or external fixation with pins. Both these procedures are surgical and patient has to consult an orthopedic surgeon.