My husband was involved in a bar fight and ended up with a broken little finger. He thinks it’s nothing and a popsicle stick to hold it together is all that’s needed. I’m wondering if he should see a hand specialist before it heals in a bad or wrong position. What do you think?

According to orthopedic experts at the George Washington University Medical Center in Washington, D.C., the solution may lie somewhere in-between. In a recently published update on the treatment of hand fractures, they suggested that many (if not most) hand fractures are adequately cared for by emergency room physicians, general orthopedic surgeons, and primary care physicians.

They would certainly agree that some type of medical care is necessary and highly recommended. An accurate and timely diagnosis is always the first step. With careful review of the patient’s history (including the mechanism of injury), physical examination, and good quality X-rays, most hand fractures can be identified and a plan of care developed. The main stumbling block in this process is making sure that all other injuries (especially soft tissue damage of nerves, tendons, and ligaments) are recognized.

Most often, surgery is not needed. Conservative (nonoperative) care consisting of short-term immobilization in a splint or cast. In some cases, a particular position of the hand and wrist is necessary to limit specific motions. And there is a danger of permanent stiffness, pressure sores, and loss of motion with prolonged immobilization. Movement of all uninvolved parts of the upper extremity is important and patients should be advised when and how to keep moving.

Special attention must be paid to intraarticular fractures (fractures that extend into the joint). This type of fracture is often accompanied by damage/rupture of the ligaments needed for joint stability. Complications are to be expected with stiffness being the most common (and most difficult to treat) problem encountered.

Fortunately, the hand is versatile, resilient, and forgiving making it possible to treat hand fractures without surgery. But in selected cases, surgery will aid and assist healing and recovery. With the right treatment, your husband can expect that, in time, it will be possible to return to normal motion and use of the involved hand.

Holding a fracture together with a popsicle stick is similar to some splinting used. But this approach must still be done under the supervision of a health care provider. One who can make sure problems and complications don’t develop and that the proper treatment is given in the right time frame to avoid more problems.