The hand is made up of many bones that form its supporting framework. A fracture occurs when enough force is applied to a bone to break it. When this happens, there is pain, swelling, and decreased use of the injured part. Some fractures will cause an obvious deformity, such as a crooked finger, but many fractures do not. Some displaced fractures may need to be set and then held in place with wires or pins without making an incision. This is called closed reduction and internal fixation. Other fractures may need surgery to set the bone. Once the bone fragments are set, they are held together with pins, plates, or screws.
Fractures that disrupt the joint surface usually need to be set more precisely to restore the joint surface as smooth as possible. On occasion, bone may be missing or be so severely crushed that it cannot be repaired. In such cases, a bone graft may be necessary. In this procedure, bone is taken from another part of the body to help provide more stability. Sometimes bone graft substitutes may be used instead of taking bone from another part of the body.