Know If Your Knuckle Is Broken

A broken knuckle can be extremely painful. It can also complicate your life if you have a career that requires you to use your hands. Sometimes it’s hard to tell whether your knuckle is actually broken or if it’s simply bruised. While a severely broken knuckle usually requires medical attention, a bruise or even a minor fracture might be able to heal on its own. Learn how to identify a broken knuckle so you can seek out the care you need.

Steps

Assessing the Immediate Situation

1. Experience a popping sensation. People who break knuckles often report feeling a popping or snapping sensation in their hand the moment the break occurs. The snapping feeling can be caused by the actual breaking of the bone or pieces of the bone popping out of their original place. If you feel this occur, it is a good idea to stop what you’re doing and examine your hand.
   • The popping sensation isn’t always present when a knuckle is broken. Whether or not you’ll experience a popping feeling depends on the severity of your fracture.
2. Identify the cause of the injury. A broken knuckle is often referred to as a “boxer’s fracture” because it occurs most often when a person punches a hard surface. When your injury happened, were you punching a wall or some other immovable surface? Maybe you were involved in a fist fight. If you have been hitting something solid, there’s a good chance you may have broken your knuckle.
   • There are other possible ways to break your knuckle that are not as common. You can break your knuckle while falling down, working with machines or doing any activity that exposes your hand to trauma.
   • Some doctors now call a broken knuckle a “brawler’s fracture” instead of a “boxer’s fracture” because boxers prevent broken knuckles by wearing protective gear. You’re more likely to break a knuckle hitting something with your bare fist.
3. Feel immediate pain. A broken knuckle will be accompanied with severe, immediate pain. Right when the injury occurs, you will experience a sharp pang in your hand which will be followed by an intense throbbing feeling. Depending on your body’s tolerance for pain, the feeling can be debilitating and force you to stop whatever you’re doing.
   • If your knuckle only has a minor fracture, the pain may not be as severe. However, you should still stop using your hand as you could further injure your knuckle.
4. Take the temperature of your hand. The moment you break your knuckle, the blood will start flowing towards the area of the fracture causing your hand to get hot. Check the temperature in your injured hand and then your other hand. If your injured hand feels much warmer than the other one, your knuckle could be broken.

Examining your Knuckle Visually

1. Check for swelling. If your knuckle is broken, it should start to swell after about ten minutes. The swelling will be centered around your broken knuckle and may spread out to the rest of your hand. The swelling from a broken knuckle may be severe. You may find it difficult to move your hand if it gets swollen enough.
   • When your knuckle starts to swell, you may experience a tingling or numb sensation as well.
   • Take aspirin, ibuprofen or another over-the-counter pain medication to decrease the swelling and deal with the pain.
   • Doctors may not be able to work on your hand if it has swollen too large. Applying ice to the injury early can help alleviate swelling. Wrap an ice pack with a paper towel and apply it to your knuckle or use a bag of frozen vegetables. Keep the ice pack on for up to 20 minutes at a time and then give your skin a chance to return to normal temperature before applying the ice pack again.
2. Look for bruising. A bruise from a broken knuckle will appear much faster than a normal bruise. As blood rushes into your injury, the area will begin to discolor within a matter of minutes. Bruising will also make your injury very tender. It will likely hurt to even touch a broken knuckle.
   • There are cases of bones breaking without any bruising present, but they are rare.
   • Keep your hand elevated to decrease bruising. Keeping your hand above your heart will allow the blood to flow away from the injury.
3. Find a sunken knuckle. A surefire way to tell if you have a broken knuckle is to see if it has sunk beneath your other knuckles. If you can, curl your injured hand into a fist and look at your knuckles. They should stick out. If there is one knuckle that you can’t see, then that knuckle is definitely broken.
   • The fracture may affect the position or angulation of your knuckle, causing it to sink.
4. Locate any areas where the skin is broken. If your bone is sticking through your skin, you have an open fracture and you will need surgery to repair it. Make sure to wash the entire area with antiseptic soap. It will be easy for any open wounds around your broken bone to become infected which will make the injury much more complicated to treat.
   • It may hurt to wash your tender knuckle, but it’s very important that you do.
   • Make sure to dry your wound completely as moisture makes it easier for bacteria to grow. You can also cover the wound with a clean dressing to prevent infection.
   • Remove any loose pieces of material from the injury. If there is an impaled object in your knuckle, leave it in place for the doctors to remove in the hospital.

Testing your Mobility

1. Bend your finger. Try to bend your injured finger to check for dislocation or malrotation of your knuckle. If your knuckle is dislocated, you may not be able to bend it at all as the bone will have moved in a way that does not allow you to use your finger. If the bone has rotated, you might be able to bend the finger, but it will be pointed towards your thumb. Malrotation means that the bone has twisted in such a way that the finger will bend in a different direction than normal.
   • If your bone is dislocated or malrotated, you will need a doctor to reset it.
   • A malrotated or dislocated knuckle often takes longer to heal than a simple broken knuckle.
2. Make a fist. If your knuckle is broken it will be very difficult for you to close your hand. You can test the severity of your injury by trying to make a fist. Your hand may have swollen too large or it may simply be too painful for you to move your fingers if your knuckle is broken. You may also be able to close all your fingers except for the one with the broken knuckle. If you can make a fist, and your knuckle is broken, your injured finger may not align properly with the rest of your fingers.
   • Don’t push yourself. If you try too hard to fight through the pain and make a fist, you could injure or dislocate your knuckle further.
3. Grip something. A broken knuckle will drastically reduce your finger strength. Your brain can shut down the muscles around a severe injury to prevent further damage. If you find yourself unable to get a tight grip on anything, there’s a chance your brain is trying to protect your broken knuckle.
   • If you have a minor fracture of your knuckle, you may still be able to use most of your grip. If you suspect you might have a fracture though, take it easy. Gripping something too hard could cause the fracture to become more severe.
4. Try out your wrist. Your knuckle is at the top of your metacarpal bone. The bottom of your metacarpal bone is connected to your carpus or wrist bone. Because the two bones are connected, a broken knuckle can affect the mobility of your wrist. Move your wrist from side to side and up and down. If you feel a sharp pain shoot through your hand, you most likely have a severe broken knuckle.
5. Seek treatment. If you suspect that your knuckle is broken, then see a doctor or visit an emergency room as soon as possible to get treated. You will probably have to wear a splint or brace for a few weeks until the knuckle heals. Casts are not often necessary for breaks in the hand and fingers.

Tips

• To keep your knuckle in place, you should splint it to another finger.
• Go to a doctor as soon as you can if you think your knuckle is broken. A doctor will be able to take an x-ray to confirm your suspicions.
• Always wrap or bandage open wounds so no bacteria can get in.

Warnings

• Avoid punching solid objects to prevent breaking your knuckles. If you spar or do martial arts, wear gear to protect your hands.
• Sometimes broken knuckles do require surgery. If surgery is required the knuckle may take even longer to heal.
• Never try to work through a broken knuckle, you could turn a minor fracture into a severe break.
• If you have a severe break that needs to be placed in a cast, it can take four to six weeks to heal. Be prepared to miss some work if your job requires you to use your hands.

Related Articles

• Treat a Broken Finger

Sources and Citations

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