Children's Hospital Colorado

Hand and Upper Extremity Fractures (Broken Bones)

What is a hand or upper extremity fracture?

A hand or upper extremity fracture occurs when a fracture, commonly known as a break or crack in a bone, occurs in the upper extremity. This includes the fingers, hand, wrist, forearm, elbow and upper arm.

An illustration showing an open fracture that breaks through the skin, a closed fracture that happens when the bone breaks but doesn't go through the skin, a displaced fracture that happens when the bones breaks and the ends are no longer straight, and a non-displaced fracture that happens when the fracture is in one spot and the bone is still straight.

What are the different types of broken bones?

The four main types of fractures include:

  • An open fracture, which occurs when the bone breaks through the skin.
  • A closed fracture, which occurs when the bone breaks but does not go through the skin.
  • A displaced fracture, which occurs when the bones break apart and are no longer straight.
  • A non-displaced fracture, which occurs when the bone break is in one spot and the bone is still straight.

What are the hand and upper extremity bones?

  • The hand and wrist have many bones, including:
    • Phalanges (finger and thumb bones)
  • Each finger has three bones
  • Each thumb has two bones
    • Metacarpals (the main bones in the palm of the hand)
    • Carpals (wrist bones)
  • The forearm (area between the wrist and the elbow) has two bones, including:
    • Radius
    • Ulna
  • The elbow connects the forearm bones to the upper arm bone.
  • The upper arm (the area between the elbow and the shoulder) has one bone, called the humerus.

What are the signs and symptoms of a fracture or broken bone?

The signs and symptoms of a bone fracture include:

  • Pain
  • Swelling
  • Loss of feeling or strength
  • It looks like a bone is no longer straight

How is a fracture diagnosed?

A broken bone is diagnosed by examination and x-rays (pictures taken to look at the bones). Sometimes your child’s doctor will order an MRI (magnetic resonance imaging) to get a closer look at the area.

How are broken bones in the hand and arm treated?

Doctors can treat most fractures by immobilizing (holding in place) the joint or bone, which is done with a splint, cast or brace.

In other cases, the broken bone will need a reduction (when your child’s doctor puts the bone in the right place or straightens the bone out).

About reductions:

  • A closed reduction means there will not be any incisions (cuts made in the skin).
  • This may be done in an emergency department, a clinic or in surgery.
  • A medicine may be injected (put in the skin with a needle) to freeze the area.
  • Sometimes children will need more medicine to make them sleepy (conscious sedation) when this is done because it can be painful.

All bone fractures will take time to heal. Activity will be limited while the bone is healing, and your child’s doctor will decide how much time is needed based on the type and location of the fracture.

In some cases your child may need surgery to fix the bone.

If surgery is needed to treat the fracture:

  • Pins, screws or plates may be needed to hold the bone in place.

What to expect after the surgery:

  • Your child’s hand will be bandaged, and sometimes your child will have a splint or cast over the bandage.
  • Your child is usually able to go home the same day as surgery.
  • Once the bone is healed, your surgeon might suggest that your child works with a hand therapist.

Why choose Children’s Colorado for treatment of your child’s hand and upper extremity fracture?

Our Hand and Upper Extremity Program team at Children’s Colorado provides a comprehensive, multidisciplinary approach to the care of your child. This means you have access to leading specialists from multiple departments who work together to treat your child.

Your child’s care team includes pediatric experts from orthopedic surgery, physical medicine, rehabilitation, occupational therapy and nursing.


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