Please be aware, the information on this page relates to Luton & Dunstable University Hospital

H9 – Metacarpal Shaft Fracture

This is a fracture near the knuckle of your hand


It normally takes 6 weeks to heal, but symptoms can continue for 3-6 months. As the bone heals a lump may form over the fracture site. Also, if you have a head/neck fracture, your knuckle may not be as prominent as before. These will not cause any functional problems with your hand.

When forming a fist, if you notice your injured finger crossing another finger, or rotating outwards, please contact the Virtual Fracture Clinic.

Smoking will slow down your healing. We would advise that you stop smoking while your fracture heals. Talk to your GP or go to for more information.

Pain and Swelling

Painkillers are important to aid your recovery and should be used as required. Stop non-steroidal anti-inflammatory drugs (NSAIDS) e.g. Ibuprofen after 5-7 days as this will slow bone healing. You may find it continues to be a bit achy and swollen for a few months after your injury. An ice pack will help initially with pain and swelling (make sure the ice is not in direct contact with the skin).

Follow up

You will receive a face to face appointment in the Fracture Clinic 3 weeks after your injury. If you have not received your appointment letter within 2 weeks please contact the Fracture clinic.

Contact us

If you are concerned about your symptoms, are unable to follow this rehabilitation plan or notice pain other than in your hand, please contact the Virtual Fracture Clinic.

Caring for your injury: splinting


If you have been given a splint this is for comfort and doesn’t affect the rate of healing. You will either have strapping applied or a “Bedford splint”. Both are correct and suitable for your injury. If you have had strapping applied, the following will advise you how to change it.

Padding should be placed between the two fingers to prevent rubbing and any breakdown of the skin. Ideally, the padding should extend almost the full length of the neighbouring finger.

Including the knuckle, each finger has 3 joints (the places where your finger bends). The exception to this is your thumb. Place 1 piece of tape around both fingers, between the first and second joints and another between the second and third. This allows the injured finger to flex or extend and can still be used to grip.

If your finger starts changing colour, or you get pins and needles sensation that wasn’t there before, then the strapping is too tight. Change the strapping daily to allow skin care.


Demonstration of strapping an injured finger with tape

Bedford Splint

Example of a Bedford splint

Plaster Cast

You may have been given a plaster of paris backslab instead of a splint. The plaster needs to be on for 3 weeks and will then be removed when you come to your Fracture Clinic appointment.

If you have any of the following please contact the plaster room on 01582 491166 (ext. 2233) Monday to Friday 9am to 5pm (out of hours contact the Emergency Department).

  • Soreness or rubbing of the cast
  • Any new pain unrelated to your existing injury e.g. persistent burning sensation under the cast
  • Any offensive smells from the cast
  • Staining or leaking through the cast from a wound discharge
  • The cast become broken, soft, dented or loose
  • The cast becomes wet

Caring for your injury: Week by Week

0 – 2 weeks since injury

  • √ – Use the strapping and splint for comfort (if you were provided with one)
  • √ – Move your fingers gently to prevent stiffness – see initial exercises

2-6 weeks since injury

  • √ – Remove the strapping when pain settles and discard splint if you were provided with one
  • √ – Start doing your normal activities within the limitations of your pain
  • √ – Progress to additional exercises
  • X – Avoid heavy lifting tasks and contact sports

6-12 weeks since injury

  • √ – The injury has healed. Swelling however can last for several months
  • √ – Heavy lifting could be painful for up to 8 weeks. Increase gradually using pain as a guide.

8+ weeks since injury

  • X – if you are still experiencing significant pain and swelling then please contact the Virtual Fracture Clinic for advice

Caring for your injury: Initial Exercises

It is important to start gentle exercises straight away to prevent stiffness. You will find pictures and instructions for your exercises below. Use your hand as normally as possible within the limitations of pain. This will not cause further damage but failure to do so may lead to ongoing stiffness.

The following exercises should be performed slowly and regularly every day, keeping the strapping on. The purpose of these exercises is to help you regain full movement.

Little and often (a few of each movement every hour) is better that doing lots of repetitions.

Exercising a hand into a fist and back to a flat palm - shortened

Starting with straight fingers, flex them into a loose fist. Initially pain, swelling and bruising will restrict movement. This is perfectly normal and to be expected. Work your way through the movements as shown in the picture above, ending with straight fingers again.

Caring for your injury: Additional Exercises

You can start these exercises after two weeks

As with the initial exercises, the following exercises should be performed slowly and regularly every day. You can now use your other hand to add gentle pressure at the end of movement, but do not force movement. Little and often (a few of each movement every hour) is better that doing lots of repetitions.

Exercising a hand into a fist and back to a flat palm

Starting with straight fingers, flex them into a loose fist. As the swelling reduces your range of movement will increase. Work your way through the movements as shown in the picture above, ending with straight fingers again.


You can do some simple exercises to help increase strength.

Use the elastic band around your fingers to strengthen the muscles in the hand.

Demonstration of the elastic band strengthening exercise

The following pictures show different ball grip exercises. Start with 5 squeezes for each exercise, holding for a couple of seconds. Rest for 2 minutes before completing a further set. Increase the amount of repetitions for each exercise as able.

Ball exercises showing: extend out, side squeeze, ball grip (both versions), and pinching

Frequently Asked Questions

I’m concerned about my symptoms and/or I am struggling to return to exercise.

Please contact the Virtual Fracture Clinic.

I am struggling with my strapping/splint. What do I do?

Contact the Virtual Fracture Clinic. We can give advice or change your splint/cast if needed.

When can I start driving?

You can return to driving when:

  • You are not using the strapping
  • You can move comfortably
  • You can control the vehicle safely

Always test your ability to drive in a safe environment first

How can I get a certificate for work?

You can self-certify for the first 7 days following your injury. For any longer periods, please discuss the provision of a fitness to work statement with the Virtual Fracture Clinic Team or your GP.

How do I contact the Virtual Fracture Clinic?

Call 01582 718121. Messages will be checked every morning Monday-Friday.