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Your hand consists of 27 bones:

• Eight bones in your wrist (carpals)
• Five bones in the palm of your hand (metacarpals)
• 14 bones in your fingers (phalanges)

These bones are connected by joints:

• The carpometacarpal (CMC) joint is where a digit's metacarpal connects to the wrist The thumb CMC joint allows for quite a bit of motion, enabling you to put your thumb in a variety of positions for grasping. There is some motion in the CMC joints of the little and ring fingers and very little motion in the CMC joints of the middle and index fingers.
• The metacarpophalangeal (MCP) joint is where your finger connects to the matacarpal
• The interphalangeal (IP) joints are the joints within your fingers. Combined, the MCP and IP joints allow you to straighten your fingers and make a fist.

Illustration showing the anatomy of the hand.

Generally, a fractured finger occurs as the result of an injury to the hand. You can fracture a finger when:

• You slam your fingers in a door.
• You put out your hand to break a fall.
• Your finger jams while trying to catch a ball.
• You have an accident while working with a power saw, drill, or other tools.
• Your hand strikes a hard object. Fractures of the metacarpal bone that attaches your little finger to your hand, which account for about one-third of all hand fractures in adults, are typically caused by a punching force (these are known as "boxer's fractures").

(Left) Illustration and (Right) X-ray of a “boxer’s fracture” in the fifth metacarpal. This common hand fracture can cause the knuckle on the affected finger to appear sunken in or angulated.

Right: Reproduced from Johnson TR, Steinbach LS (eds): Essentials of Musculoskeletal Imaging. Rosemont, IL American Academy of Orthopaedic Surgeons, 2004, p. 347.

• Swelling of the fracture site
• Tenderness at the fracture site
• Bruising at the fracture site
• Inability to move the injured finger completely
• Deformity of the injured finger

If you think you fractured your finger, immediately tell your doctor exactly what happened and when it happened. Your doctor must determine not only which bone(s) you fractured, but also how the bone(s) broke.

Bones can break in several ways:

• Straight across the bone
• In a spiral pattern
• Into several pieces
• Shattered completely

Illustration showing different types of finger fractures. (Left) With intraarticular fractures, the fracture extends into the joint. (Right) Avulsion fractures occur when a ligament or tendon and a small piece of the bone it is attached to pull away from the main bone.

Your doctor may want to see how your fingers line up when you extend your hand or make a fist. Does any finger overlap its neighbor? Does the injured finger angle in the wrong direction? Does the injured finger look too short?

Your doctor will obtain X-rays and sometimes advanced imaging tests, such as a computed tomography (CT) scan, to better understand the fracture and how it should be treated.

Your doctor will also look for injuries to other nearby structures. It is not uncommon for a finger that is fractured to also have injuries to tendons, nerves, and/or ligaments. These injuries may need to be treated along with the broken bone(s) to ensure a good outcome. 

You may begin using your hand again as soon as your doctor determines it is OK to move your finger. Doing simple rehabilitation exercises each day will help reduce the finger's stiffness and swelling. You may be required to see a hand therapist to assist you in these exercises.

Outcomes following the treatment of finger fractures vary:

• Some simple fractures are easily treated, and treatment results in excellent function.
• Some more catastrophic injuries (e.g., a gunshot to the finger) — in which multiple structures (such as tendons, nerves, and/or ligaments) are involved — result in stiff and poorly functioning fingers even with the best treatments. In some cases, a second or third surgery may be needed to remove hardware once the bone is healed or to free up tendons that have scarred to the fracture site.

 If you suspect you have a finger fracture, seek treatment as soon as possible. The sooner a fracture is addressed by a doctor, the better the outcome will likely be.