Hand fracture surgery restores the alignment and stability of broken bones in the fingers, thumb and palm, so that the hand can move, grip and pinch as it should. Fractures of the hand are among the most common injuries seen in adults, caused by falls, sport, accidents at home and work, or a punch. At our Harley Street practice in London, Ms Anna De Leo, a GMC-registered Consultant Plastic and Reconstructive Surgeon with the European Diploma in Hand Surgery and specialist microsurgical training, offers timely assessment and treatment tailored to each injury.
Many hand fractures heal very well with a splint, buddy strapping and early guided movement, and surgery is recommended only when it offers a clearly better outcome. Where a fracture is displaced, rotated, unstable or involves a joint, careful fixation with fine wires, screws or a small plate can make a lasting difference to how the hand works.
01Understanding Hand Fractures and Hand Fracture Surgery
The hand contains 27 bones: the small carpal bones of the wrist, five metacarpals that form the palm, and fourteen phalanges in the fingers and thumb. These bones are linked by finely balanced joints, tendons and ligaments, which is why even a small fracture that heals slightly crooked, short or rotated can affect grip, cause fingers to cross when making a fist, or leave a joint stiff and painful.
Hand fractures are described in several ways, each of which influences treatment:
- Closed or open: whether the skin over the fracture is intact or broken. Open fractures carry a risk of infection and need urgent care.
- Simple or comminuted: whether the bone is in two pieces or several fragments.
- Extra-articular or intra-articular: whether the fracture line stays within the shaft of the bone or extends into a joint surface.
- Stable or unstable: whether the fragments are likely to stay in position while healing.
Common examples include the “boxer’s fracture” of the fifth metacarpal, fractures at the base of the thumb such as a Bennett fracture, finger fractures from ball sports, and small avulsion fractures where a tendon or ligament pulls off a fragment of bone, as in mallet finger. Symptoms usually include pain, swelling, bruising, difficulty moving the finger and sometimes visible deformity, numbness or tingling.
If the skin is broken, the finger is cold or pale, or there is heavy bleeding, please attend your nearest Emergency Department straight away. For closed injuries, early specialist assessment within the first few days is ideal, because the window for correcting a displaced fracture without more complex surgery is relatively short.
02Diagnosis and Non-Surgical Treatment
Ms Anna De Leo begins with a careful history of how the injury happened and a thorough examination of the hand. She checks swelling, skin integrity, circulation, sensation and tendon function, and, importantly, looks for rotation by watching the fingers as you gently curl them: in a well-aligned hand, all fingertips point towards the same area of the wrist. X-rays in several views confirm the fracture pattern, and a CT scan is occasionally needed for complex joint injuries.
A large proportion of hand fractures are best treated without surgery. Options include:
- Buddy strapping to a neighbouring finger for stable fractures, allowing early movement.
- A custom thermoplastic splint or cast that holds the hand in a safe position while the bone heals.
- Closed reduction, gently manipulating the fracture back into alignment under local anaesthetic, followed by splinting.
- Hand therapy from an early stage to control swelling and prevent stiffness, which is the most common long-term problem after hand injuries.
Follow-up X-rays in the first two weeks check that the bones stay in position. Hand fracture surgery is recommended when a fracture is displaced or rotated, unstable, involves a significant part of a joint surface, is open, or forms part of a more complex injury with tendon or nerve damage.
03Your Assessment on Harley Street
Appointments take place at 64 Harley Street in Marylebone, and the practice is open every day by appointment, which helps when an injury needs prompt review. Please bring any X-rays, discharge letters or reports from an urgent care centre or Emergency Department so that treatment can continue without delay.
Ms De Leo will explain the fracture in plain language, using the images to show what has happened, and outline the options with their advantages and drawbacks. She will consider your work, dominant hand, sport and the demands of daily life, because the right treatment for a professional musician may differ from that for a rugby player.
Patients often ask about hand fracture surgery cost factors. The personalised plan depends on the type and complexity of fracture, imaging needs, the method of fixation and implants used, the type of anaesthetic, the facility and the amount of hand therapy required. Each element is explained clearly before you decide. For anyone seeking a hand fracture specialist near Marylebone or elsewhere in central London, the clinic is easily reached from Oxford Circus, Bond Street and Regent’s Park.
04How Hand Fracture Surgery Is Performed
The aim of hand fracture surgery is to restore alignment and hold the bone securely enough to allow early movement, while disturbing the surrounding soft tissues as little as possible. Depending on the fracture, the procedure may be performed under a wide-awake local anaesthetic, a regional block that numbs the whole arm, or a general anaesthetic, usually as a day case.
Fixation methods are chosen for each individual fracture:
- Kirschner wires (K-wires): fine wires inserted through the skin, often without opening the fracture site, to hold the bone after it has been realigned. They are typically removed in clinic after three to five weeks.
- Lag screws: small screws that compress long, oblique or spiral fractures, providing stability that allows early movement.
- Mini-plates and screws: low-profile implants used for unstable, comminuted or shortened fractures, particularly of the metacarpals.
- Joint reconstruction: careful restoration of the joint surface in intra-articular fractures, sometimes with dynamic external devices that allow movement while healing.
Ms De Leo’s training in reconstructive microsurgery is especially valuable in complex injuries, where tendons, nerves, blood vessels or skin may be damaged alongside the bone and need repair at the same time. Throughout, the guiding principle is gentle handling of tissues, since the gliding layers around tendons are easily scarred.
A broken finger is never ‘just a finger’: alignment measured in millimetres and movement started early decide how well the hand works for years.
ADLSynergy · Harley Street
05Hand Fracture Surgery Recovery Time
Recovery after a hand fracture is as much about movement as about bone healing. Stiffness can develop quickly, so an early, guided hand therapy programme is a central part of treatment.
- First week: keep the hand elevated to reduce swelling; a protective splint is worn and gentle exercises usually begin within days, guided by your therapist.
- Weeks 1–3: wound check and suture removal at around two weeks; most people can manage desk work within one to three weeks, depending on the fracture and dominant hand.
- Weeks 3–6: X-rays confirm healing; K-wires, if used, are removed; splint use is gradually reduced.
- Weeks 6–12: strengthening and return to driving, lifting and most activities; contact sport usually waits until bone and soft tissues are robust.
Swelling and some stiffness can continue for several months, and full strength may take three months or longer. Follow-up is arranged at our Harley Street clinic in London, with support from the ADLSynergy recovery team for scar therapy and wellbeing.
06Hand Fracture Surgery Risks and Realistic Results
Most hand fractures heal well with appropriate treatment, including hand fracture surgery where needed, but outcomes vary with the severity of the injury, and every operation carries risks. These include:
- Stiffness, the most common problem after any hand fracture, whether treated surgically or not.
- Infection, particularly around wires or after open injuries.
- Malunion (healing in an imperfect position) or, rarely, non-union.
- Tendon adhesions, sometimes requiring a later release.
- Irritation from implants, occasionally needing removal of a plate or screw.
- Injury to small nerves or blood vessels, and complex regional pain syndrome, both uncommon.
- Arthritis in the longer term after joint fractures.
A realistic “before and after” for a hand fracture is a hand that grips strongly, fingers that align when you make a fist, and a return to the activities that matter to you, achieved through partnership between surgeon, therapist and patient.
07Why Choose Ms Anna De Leo on Harley Street
Ms Anna De Leo holds the European Diploma in Hand Surgery, an International Master’s Degree in Reconstructive Microsurgery and a Diploma in Microsurgical Techniques, and is a Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery. Her experience of hand trauma spans more than twenty years, including London NHS hospitals such as Chelsea and Westminster and the Royal Free, Oxford University Hospitals, and international experience at João XXIII Hospital in Belo Horizonte, Brazil, Hospital de Sant Pau in Barcelona and Helsinki University Hospital.
As a female surgeon trained in both bone fixation and soft-tissue reconstruction, she treats the whole injured hand, not just the X-ray. Read more about Ms Anna De Leo and our Harley Street practice in London, or contact us to arrange prompt assessment of a hand fracture and to discuss whether hand fracture surgery is right for you.
