The majority of metacarpal fractures can be treated conservatively. Treatment options: fracture fixation with K-wires, interfragmentary screws, or mini plates.Deformities leading to functional impairment: severe angulation, shortening, or malrotation.Displaced fractures with a step-off of > 1 mm or subluxation/ dislocation of the CMC joint. In addition, pain can be produced by grabbing the finger that attaches to the metacarpal. A wrist that does not flex or extend to allow normal use. Intraarticular fractures occupying > 25% of the articular surface The doctor may be able to produce pain by pressing on the broken bone. Symptoms Angulation (bend) and/or rotation of the fractured bone.5 th metacarpal fractures : ulnar gutter splint/cast or twin taping to the ring finger.Due to the unique biomechanics and anatomy of the thumb, fractures of the first metacarpal are classified separately. Fractures of the second, third, fourth, and fifth metacarpals are subdivided into those affecting the metacarpal head, neck, shaft, or base. 2 nd–4 th metacarpal fractures: palmar wrist splint/cast Overview Metacarpal fractures are classified anatomically.1 st metacarpal fractures: short-arm thumb spica splint.4 weeks, depending on physical examination findings Mild deformity is often preferable to surgical treatment.Simple, closed, and stable metacarpal fractures.This type of fracture has therefore become to be known as a boxer’s fracture. They classically occur in the small finger or metacarpal bone in boxers or athletes of other sports or activities. Ensure concomitant injuries and/or infections are also treated. A metacarpal fracture or broken metacarpal is a fracture (break) of the tubular bones within the palm (metacarpals).See “ General fracture care” in “ General principles of fractures.”.Type IV metacarpal base fracture: a pediatric physeal fracture, most commonly a type II Salter-Harris fracture (see “ Pediatric fractures”).Type III metacarpal base fracture: transverse or oblique fracture of the metacarpal base.The fragments often form a T- or Y-shaped pattern.Comminuted fracture of the metacarpal base.Type II metacarpal base fracture ( Rolando fracture).The 1 st metacarpal shaft fragment is radially and proximally dislocated by the pull of the abductor pollicis longus muscle.Two-part fracture of the metacarpal base.Type I metacarpal base fracture ( Bennett fracture-dislocation) Fractured hand symptoms involving the metacarpals include pain, swelling, general tenderness along the site of the injury, and bruising.Type of fracture: transverse, oblique, spiral, comminuted (see “ Fracture classification” in “ General principles of fractures”).A fracture of the 4 th or 5 th metacarpal neck is called a boxer's fracture because it is usually caused by a closed fist forcibly coming into contact with a solid surface.In a Boxers fracture, the symptoms will be present at the. Fractures of the metacarpal head, neck, base, and shaft Tenderness, pain, and swelling over the affected area are the hallmarks of a metacarpal fracture.
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