Treatment of Metacarpal fractures

April 24th, 2007

Fractures of the Hand's metacarpals can be treated by a variety of techniques, including nonoperative use of a cast or splint-- when nondisplaced-- or with the use of pins and/or plates and screws when the fracture is not adequately aligned.

When surgery is required,low profile plates and aggressive therapy after surgery allow, in most cases, full restoration of function. During your visit, I will discuss the options, understand your preferences, and make a recommendation aimed at delivering the highest value of care to you.

Related Photos:

PA xray shows 3rd and 4th metacarpal fractures that are amenable to closed treatment in a brace. There was no clinical evidence of malrotation

Lateral xray shows no significant angulation

A hand based brace may be used as an alternative to a more substantial brace, in some cases

Healed metacarpal fractures on final PA xray

Excellent appearance to the hand after closed treatment

Excellent grip after healing without the need for surgery in this case

Case 2. Comminuted but reasonably aligned 4th metacarpal fracture is amenable to closed treatment with K-wires (no incisions)

K wires are placed to stabilize the metacarpal until union

4th metacarpal fracture has healed and the K wires have been removed

Case 3. Multiple metacarpal fractures with angulation. This is an excellent indication for open reduction and fixation with low profile plates and screws, which will allow early range of motion

Lateral xray shows angulation of the 4th and 5th metacarpal fractures

Postoperative PA xray

Postoperative lateral xray

Well healed incision on the ulnar dorsal aspect of the hand

Excellent grip after union