Musculoskeletal system

Broken knuckle-4 Causes, 7 Symptoms, 4 Complications, Diagnosis, 11 Treatments

Broken knuckle or fractured knuckle is very uncomfortable for a person as it affects and limits the daily life activities done with the hand. The hand is a very important part of our body, and we need it to do innumerable tasks in our daily life.

Do you know what a knuckle is? Knuckle is the joint that appears prominently when you make a fist or clench your hand. Knuckles are the joints between the fingers and the hand.

There are 5 knuckle joints in each hand and they are also known by the name of metacarpophalangeal joints. These knuckles in each hand are formed by 10 knuckle bones, which are the 5 metacarpal bones of the hand and the 5 proximal phalanges of the fingers.

Broken knuckle or fractured knuckle can develop if we hit any hard thing like the floor, or anything else due to many reasons like fights, accidents, etc. Fractured knuckle can be relieved by using many home remedies, and very rarely it needs surgical intervention.

Broken knuckle Causes:

Broken knuckle
Broken knuckle
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There are several causes of developing a fractured knuckle. Most of them revolve around having trauma leading to this problem. Let us explore the causes:

Motor vehicle accidents:

When there are any motor vehicle accidents, if you fall with your clenched fist or your fist hits some hard object, it is likely that you develop fractured knuckle.

Domestic violence:

Domestic violence is a very unfortunate thing to experience. When a family member hits you to the ground or to the wall, your knuckle can get hurt badly and you might develop a broken knuckle.

Contact sports:

There are many types of contact sports like rugby, martial arts and soccer which can lead to broken knuckle either by falling on the arm with knuckle hitting the ground or by your knuckle hitting your opponent.

Accidents at work:

There are many people who develop broken knuckle at work due to falls on hand or hand hitting something hard.

Broken knuckle Symptoms:

There are many symptoms of a broken knuckle. Let us explore them below:


Pain is the most common and immediate symptom of the broken knuckle. The severity of pain that you develop due to broken knuckle depends on the severity of the injury causing fractured knuckle.

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There may be varying degrees of pain in various people ranging from mild pain to excruciating pain. In some people, movement or flexion of the knuckle is possible without having any pain even though they have a broken knuckle.


Swelling of the broken knuckle develops within 30 minutes after developing the injury. This swelling of the knuckle makes the movement of the hand difficult. This swelling might also spread to involve other fingers of the hand which were not affected.


Due to the broken knuckle, there is severe swelling of the knuckle. This swelling exerts pressure over the nerves supplying the knuckle and these nerves get compressed. Due to this, the sensations over the knuckle are not felt and you experience numbness.


Broken knuckle leads to swelling over the knuckle which in turn can lead to numbness and also stiffness. The knuckle becomes very stiff and it becomes very difficult to move the hand. Stiffness in the knuckle might persist even after the broken knuckle has healed completely. Stiffness can decrease the mobility of your hand for a prolonged period of time.

Depressed knuckle:

When we develop a broken knuckle, the part of the hand or the knuckle which is injured becomes depressed or it is sunken inside the hand. If you notice that your knuckle is retracted, it gives you a very good idea that your knuckle is broken.

Popping feeling:

Popping sensation or feeling is a very common symptom of the broken knuckle that people experience. When your knuckle hits a hard thing like wall or ground or anything that has caused fractured knuckle in you, you will immediately hear a popping sound. This popping indicates that your knuckle has broken into pieces.


Broken knuckle can lead to heavy bleeding from the bones of the hand. This leaked blood accumulates below the skin and develops into a bruise. This bruise over the knuckle develops very fast than expected.

Broken knuckle Complications:

Getting infected:

The bacteria try to infect anything that is damaged in the body pretty fast. When we have a broken knuckle, the bacteria infect the injured knuckle and might even lead to osteomyelitis. This infection of the bone might spread into the bloodstream if not treated promptly with antibiotics which might even lead to septicemia.

Delayed union:

The broken knuckle might take a prolonged time to heal and for the broken bones to join together. This process is called the delayed union. Healing of the broken knuckle depends on several factors like the development of infection, health status and age of the affected person.

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Sometimes even though you have taken appropriate treatment and remedies for the broken knuckle, it might not heal properly and there can be the development of abnormal shape of the knuckle or shortening of the bones of the knuckle after healing.


Even after correct treatment, in some people, the broken knuckle may not heal properly and the bones of the metacarpophalangeal joint are not joined together like before. This is called nonunion.

Broken knuckle Diagnosis:

There are several steps in the diagnosis of a broken knuckle. They are:


At first, your physician will take a detailed history of how you have developed the injury. He will also ask you about the symptoms that you are suffering from like pain, stiffness, etc. He will also ask you about any history of diseases like Diabetes, hypertension which might affect the healing of the broken knuckle.

Physical examination:

Then after taking a proper history, your physician will examine your knuckle and hand carefully. He will make note of any changes in the knuckle like swelling, redness, bruising, depression or retraction of the knuckle, etc which might point out that you have developed a fractured knuckle. He will also press your knuckle and see if you have any tenderness over the area.

Radiological tests:

After taking a detailed history and doing a careful physical examination, your physician will order some radiological tests like x-ray and CT scan. These tests will confirm that you have developed a broken knuckle.

Broken knuckle Treatment and Remedies:

There are many treatment options or remedies for a broken knuckle. Some of them include home remedies and some of them are surgical interventions. Let us explore them:

Cleaning the wounds:

When you develop fractured knuckle, you are most likely to develop cuts or abrasions of the skin over your knuckle. So, you need to clean these cuts properly using antiseptic solution and soap.

Then you need to cover the cuts using some gauze piece. If the wounds are not cleaned promptly, bacteria can invade the knuckle through the cuts and can develop a bone infection or osteomyelitis.

Cold compress:

Using an ice pack or cold compress over the broken knuckle is the surest way to reduce the pain and swelling associated with the fractured knuckle. Just take few ice cubes and then place them in a Ziploc bag or in a cloth towel. Then apply this cold compress over the fractured knuckle for few minutes several times a day.


Initially, the broken knuckle or fractured knuckle is immobilized while the knuckle is placed in fist position for few weeks using braces. This immobilization of fractured knuckle is done until the knuckle is healed.

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Knuckle elevation:

You need to keep your knuckle or hand elevated at all times. This helps to reduce blood getting accumulated in the knuckle so that the swelling and pain of knuckle reduces eventually.

Buddy wrapping or buddy tapping:

After the swelling has subsided in the fractured knuckle, you need to make the finger of the broken knuckle and the finger next to it straight. Then keep a small piece of cotton between the two fingers.

Then tie the two fingers including the one with broken knuckle together while keeping them straight. This helps in healing of the fractured knuckle properly. You might need to continue the buddy wrapping process until about a month or so, as it takes time for the broken knuckle to heal.


If you are worried about keeping the finger with fractured knuckle strapped to the adjacent normal finger, then you can strap the broken knuckle finger along with a splint. Then keep this as it is straight for about a month to facilitate proper healing of the fractured knuckle.


Broken knuckle is really very painful. So you need to take analgesic medicines or anti-inflammatory medicines like NSAIDs. They include drugs like aceclofenac, diclofenac, celecoxib, etc. They help to reduce the pain and swelling associated with the broken knuckle.

Plate fixation:

If the broken knuckle is very severely fractured and it cannot be cured with simple remedies and interventions, then your doctor might decide to place the plate in your hand and fix it with the knuckle using screws. This is left in the hand permanently.

External fixation:

In this method, the bones forming the fractured knuckle are joined together and kept together using pins. These pins are placed in position using rods made of metal.


They are also metal rods used for fixation of the fractured knuckle. They are removed from the body easily after the broken knuckle is healed.

Interosseous wires:

They are wires which are thin and are used for fixation of the bones of the fractured knuckle together. They are left permanently in the hand after the fractured knuckle is healed. But they don’t generally cause any problem.

Broken knuckle Prevention:

Broken knuckle is almost always caused by falls, hitting hard things or surfaces, fights or brawls, motor vehicle accidents, contact sports, etc. So avoiding all these trigger factors to prevent fractured knuckle.

Just use proper safety equipment like gloves, etc while playing contact sports. Don’t involve in fights or brawls. Drive safely and follow all rules while driving. Don’t hit anything with clenched hand or fist.

You have seen all the possible causes, symptoms, diagnosis and the treatment options available for the broken knuckle. Hope you find the article informative.

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