Non-thumb metacarpal fracture (shaft): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "* " to "*") |
Neil.m.young (talk | contribs) (Text replacement - "==Treatment==" to "==Management==") |
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{{Hand and finger fractures DDX}} | {{Hand and finger fractures DDX}} | ||
== | ==Management== | ||
*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]] | *[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]] | ||
*Acute reduction indicated if there is pseudo-clawing or significant angulation | *Acute reduction indicated if there is pseudo-clawing or significant angulation | ||
Revision as of 18:03, 7 July 2016
Examination
- TTP along affected metacarpal
- Flexion at MCP is difficult
- Assess for extensor dysfunction; patient may exhibit "pseudo-clawing" during attempts at finger extension
- Assess angulation
- >10 deg in 2nd and 3rd and >20 deg in 4th and 5th metacarpal shaft fractures requires reduction
- Assess rotational alignment
Imaging
- Oblique fracture are more prone to shorten and rotate
- Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fx)
Differential Diagnosis
Hand and Finger Fracture Types
Management
- Ulnar Gutter Splint or Radial Gutter Splint]
- Acute reduction indicated if there is pseudo-clawing or significant angulation
- Closed reduction generally corrects angulation but typically does not restore length
Disposition
- Refer:
- Malrotation
- Comminution
- Shortening > 5mm (refer all shortening if not familiar with fracture management)
- 2 or more metacarpal fractures
- Unacceptable angulation
- Long oblique fractures