Non-Operative Metacarpal Fracture Management: Evidence-Based Introduction Metacarpal fractures are a commonly encountered orthopedic injury.
Non-Operative Metacarpal Fracture Management: Evidence-Based Metacarpal fractures are a commonly encountered orthopedic injury. Metacarpal fractures can occur at the head, neck, shaft, or base of the metacarpal. When evaluating fractures of the metacarpals, knowledge of the surrounding musculature is required.
The dorsal and palmar interosseous muscles originate from the metacarpals. The role of the dorsal interosseous muscles is finger abduction and extension and the palmar interosseous muscles is finger adduction. The metacarpals are also flanked by the extensor tendons, flexor tendons, and lumbricals .
Each metacarpal is also supported by a volar plate ligament located on the palmar surface and these are connected by the deep transverse metacarpal ligaments. Diagnosis is typically made with a three view xray. This data is especially useful to sideline physicians who may have portable ultrasound immediately available which can be used in lieu of radiographs.
In this article, we will review the different fracture types and evidence behind treatment regiments. Metacarpal Head Fractures Metacarpal head fractures are less commonly seen than the other metacarpal fracture types. The most commonly seen metacarpal head fracture is the second metacarpal due to its decreased mobility.
These fractures are most commonly seen in sporting injuries and fights. Metacarpal head fractures typically involve the articular surface and those that involve less than 20% of the articular surface can be managed conservatively. In order to preserve the MCP collateral length the fracture can be immobilized in a radial or ulnar gutter splint.
If you are experiencing symptoms that may be related to evidence behind the non-operative management of metacarpal fractures, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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