Is it possible for a hand fracture to be missed on an x-ray?

Sure is: Fractures in the hand can be subtle. Generally 3 views of the hand are needed to accurately assess the presence or absence of a fracture. Some fractures that are not displaced might only become apparent on xray after 7-10 days. Features of hand fractures include swelling, deformity, and point tenderness. If a question exists, see a hand surgeon.

Definitely: There are quite a few subtle fractures of the hand that can be easily missed on the first round of X Rays. it is only when X Rays are repeated in a few weeks then the signs of a healing fracture are seen. A fracture of the scaphoid bone in the wrist is pretty well known for being missed initially. If there is clinical suspicion, a CT scan can be organised to confirm or rule out a fracture