Hand and Wrist Injury

By David A. Thompson, M.D. 
March 22, 2017

911 warning

Hand and Wrist Injury

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Does this describe your symptoms?

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Bruise from Coumadin

First Aid - Bleeding Arm

First Aid - R.I.C.E.

First Aid - Sling - How to Put On

First Aid - Splint for Wrist Injury

X-Ray - Wrist Fracture

Wrist Fracture with Deformity


  • Injury to a bone, muscle, joint or ligament of the hand and wrist

Types of Injuries

  • Fractures (broken bones)

  • Dislocations (bone out of joint)

  • Sprains - Stretches and tears of ligaments

  • Strains - Stretches and tears of muscles (pulled muscle)

  • Contusion (bruise) - A direct blow or crushing injury

If not, see these topics

First Aid:

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for a Sprain or Twisting Injury of Hand or Wrist:

  • Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

  • Wrap area with an elastic bandage.

FIRST AID Advice for Suspected Fracture or Dislocation of Hand or Wrist:

  • Immobilize the hand and wrist by placing them on a rigid splint (e.g., small board, magazine folded in half, folded up newspaper).

  • Tie several cloth strips around hand/wrist to keep the splint in place.

  • Place injured arm in a sling. If no sling is available, victim can support the injured arm with the other non-injured hand.

  • Option - Soft Splint: Immobilize the hand and wrist by wrapping them with a soft splint (e.g., a pillow, a rolled-up blanket, a towel). Use tape to keep this splint in place.

Transport of an Amputated Body Part:

  • Briefly rinse amputated part with water (to remove any dirt).

  • Place amputated part in plastic bag (to protect and keep clean).

  • Place plastic bag containing part in a container of ice (to keep cool and preserve tissue).


When to Call Your Doctor

call 911

Call 911 Now (you may need an ambulance) If

  • Major bleeding (actively bleeding or spurting) that can't be stopped

  • Limb has been partially or completely amputated

  • Note: For bleeding, see First Aid

call now

Call Your Doctor Now (night or day) If

  • You think you have a serious injury

  • Injury looks like a dislocated joint (crooked or deformed)

  • Severe pain

  • High pressure injection injury (e.g., from paint gun, usually work-related)

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think you need to be seen

  • Can't use injured hand normally (e.g., make a fist, open fully, hold a glass of water)

  • Very large bruise follows a minor injury (wider than 2 inches)

  • Several bruises occur without any known injury

  • You are over age 54, have osteoporosis, or use steroid medications routinely

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Injury interferes with work or school

  • Injury and pain have not improved after 3 days

  • Injury is still painful and swollen after 2 weeks

home care

Self Care at Home If

  • Minor bruise

  • Minor strained (pulled) muscle or sprained (stretched) ligament



  1. Treatment of Bruise (e.g., direct blow to hand or wrist):

    • Apply a cold pack or an ice pack (wrapped in a moist towel) to the area for 20 minutes each hour for 4 consecutive hours. (20 minutes of cooling followed by 40 minutes of rest for 4 hours in a row).

    • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.

    • Rest the injured part as much as possible for 48 hours.

  2. Treatment of Sprains and Strains:

    • FIRST AID - Wrap with a snug elastic bandage. Apply an ice pack (crushed ice in a plastic bag covered with a moist towel) to reduce bleeding, swelling, and pain.

    • Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.

      • REST the injured part for 24 hours. You may return to normal activity after 24 hours of rest if the activity does not cause pain.

      • Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first two days.

      • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you experience numbness, tingling, or increased pain in the injured part, the bandage may be too tight. Loosen the bandage wrap.

      • Keep injured hand or wrist ELEVATED and at rest for 24 hours. Put your hand and wrist on a pillow positioned above heart level.

  3. Pain Medicines:

    • For pain relief, take acetaminophen, ibuprofen, or naproxen.

    Acetaminophen (e.g., Tylenol):

    • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.

    • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.

    • The most you should take each day is 3,000 mg.

    Ibuprofen (e.g., Motrin, Advil):

    • Take 400 mg by mouth every 6 hours.

    • Another choice is to take 600 mg by mouth every 8 hours.

    • Use the lowest amount that makes your pain feel better.

    Naproxen (e.g., Aleve):

    • Take 250-500 mg by mouth every 12 hours.

    • Use the lowest amount that makes your pain feel better.

    Extra Notes:

    • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An acetaminophen overdose can hurt the liver.

    • Caution: Do not take acetaminophen if you have liver disease.

    • Caution: Do not take ibuprofen or naproxen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of medicine. Do not take ibuprofen or naproxen for more than 7 days without consulting your doctor.

    • Before taking any medicine, read all the instructions on the package

  4. Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.

  5. Call Your Doctor If:

    • Pain becomes severe

    • Pain does not improve after 3 days

    • Pain or swelling lasts more than 2 weeks

    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.


March 22, 2017