Title: Metacarpal Fractures<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p>
<strong>Metacarpal Fractures</strong></p>
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* Localize fracture to head, neck or shaft (neck most common)</p>
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5th metacarpal most commonly fractured</p>
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* Note amount of angulation, shortening and the presence of malrotation</p>
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*Treatment is based on which metacarpal is fractured and the location of the fracture</p>
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*The amount of acceptable angulation varies by the digit involved</p>
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For example for index and long finger - acceptable angulation of the shaft is 10-20 degrees and neck is 10 to 15 degrees</p>
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Whereas for the 5th digit - acceptable angulation for the shaft is 40 degrees and neck is 50 degrees</p>
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<strong>Pearls</strong></p>
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No degree of malrotation is acceptable (document the absence of this!)</p>
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Strongly suspect fight bite injury with abrasions/lacerations overlying metacarpal heads</p>
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Highly prone to infection given the proximity to the joint capsule</p>
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Consider lacerations over metacarpal fractures as open fractures (do not close/discuss management with hand surgery re timing of washout. Many prefer delayed fixation for suspected infections )</p>
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Document integrity of the extensor tendon (can be lacerated and retracted)</p>