The most common cause of a broken knuckle is punching a hard surface, such as a wall or a door. Other common causes include fights, contact sports, and accidental falls.

Broken knuckles, also known as metacarpal fractures, are common. They account for approximately 18 to 44 percent of all hand fractures. Just over three-quarters of all knuckle fractures occur among men, and they are more common among teens and young adults.

A fractured knuckle isn’t life-threatening, but it does require treatment to heal properly. Read on to find out more about symptoms, diagnosis, and treatment of broken knuckles.

A fracture can leave your knuckle and the surrounding parts of your hand feeling sore or tender. It might hurt to bend your fingers or make other hand movements. You might not be able to move the affected finger at all. The knuckle might look concave or sunken.

Common symptoms of a broken knuckle typically appear close to the site of the fracture. They can include:

  • pain, swelling, or numbness
  • cut or pierced skin
  • difficulty moving parts of the hand
  • depressed knuckle
  • misaligned or shortened fingers
  • deformity
  • bruising or discoloration
  • popping or cracking sound

A knuckle fracture occurs when one or more of your knuckles makes forceful contact with an object or person. The hand can be closed in a fist or open when the contact occurs.

Punching a wall or a door is the most common cause of a broken knuckle. Accidental falls are another common cause. Among athletes, a fractured knuckle could be the result of direct impact with another player, a playing surface, or a ball, stick, or bat.

Your doctor may ask you about the injury and symptoms. They will conduct a physical examination of the affected hand and fingers. This will likely include checking your tendons and joints.

Wounds and cuts around the knuckle can indicate that something is stuck in your hand. They can also indicate an open fracture, in which the bone has broken through the skin.

If your doctor has reason to believe that one or more or your knuckles is fractured, they will order X-rays. Your doctor will use several X-rays taken from different angles to make a thorough check for the fracture. Sometimes, additional X-rays or other imaging tests are used to provide more details about the injury.

Broken knuckle pictures

In the short-term, broken knuckle treatment focuses on alleviating pain and swelling. The long-term goal of treatment for a broken knuckle is to keep the bone aligned while it heals.

Broken knuckles don’t usually require reduction, a procedure in which the doctor snaps the broken bone back into place. However, it depends on the type, location, and severity of the break.

Cold therapy

In the immediate aftermath of a knuckle injury, apply a cold pack to the affected area to minimize pain and swelling. Keeping your hand still and in an elevated position can also help.

Immobilization

Immobilization is a technique that involves keeping the broken knuckle in place so that it can heal. This can be done by taping two fingers together, a technique known as buddy taping. It’s also done using a splint or a cast. The splint or cast may be applied to the finger, hand, or entire wrist area.

Your doctor will let you know how long you need to wear the tape, splint, or cast. It may be several weeks to a month.

Medications

Your doctor might suggest over-the-counter medication to target pain caused by a broken knuckle. If your pain is severe, your doctor might prescribe something stronger, such as codeine.

Other medications include antibiotics, which are used to prevent infection on cuts or wounds near the injury.

Broken knuckle surgery

Most knuckle fractures do not require surgery. However, your doctor might suggest surgery if:

  • your fracture extends into the joint
  • you have an open fracture
  • pieces of the bone are unstable
  • the surrounding tissues are damaged
  • you have multiple fractures in the same area
  • you’ve had other hand or wrist fractures in the past
  • the degree of displacement of the fracture is severe

The surgical procedure depends on a number of factors, including the location and severity of the fracture.

Internal fixation

Internal fixation procedures involve making an incision, realigning the knuckle, and using special pins, wires, screws, or plates to stabilize it.

External fixation

External fixation procedures involve using pins to secure a metal frame around your finger or hand. The metal frame keeps your knuckle in place while it heals. Once your knuckle heals, the frame is removed.

Recovering from a broken knuckle can be challenging. You might not have full use of the affected hand and fingers for a while.

You might have to wear a cast or a splint for several weeks. A doctor might take more X-rays after two or three weeks in order to ensure your knuckle is healing properly.

For a swift recovery, follow a doctor’s instructions to the best of your ability. You can’t always control how long it takes your body to heal. A number of factors, including your overall health, can impact healing time.

Therapy

Your doctor might suggest therapy to help with recovery. Physical therapy involves performing stretches and exercises to improve range of motion and reduce pain and stiffness in your knuckle and the surrounding area.

Occupational therapy involves making adaptations to your regular routine at home and at work. These adaptations can help you ease into using your hand and fingers again.

It can take several months or more of therapy before you regain full use of your hand.

Pain management

Pain from a broken knuckle should lessen after your knuckle has been treated. However, you might still feel mild to moderate pain as your knuckle heals. To manage pain caused by a broken knuckle, try holding your hand above heart level.

Follow your doctor’s instructions when taking over-the-counter or prescription medication. If the pain is unmanageable, tell your doctor.

Broken knuckles are a common injury that can result from punching something with force or hitting your knuckle against a hard surface. A broken knuckle requires medical treatment.

With treatment, most broken knuckles heal well. You should regain full use of your hand.