Non-thumb metacarpal fracture (head): Difference between revisions
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*Swelling, decreased ROM, and TTP of MCP joint | *Swelling, decreased ROM, and TTP of MCP joint | ||
*Assess for rotational alignment (rotational malalignment is not tolerated) | *Assess for rotational alignment (rotational malalignment is not tolerated) | ||
*Assess for skin integrity ( | *Assess for skin integrity (rule out fight bite) | ||
==Imaging== | ==Imaging== | ||
Revision as of 03:47, 31 July 2016
Background
- Intra-articular fracture
Examination
- Swelling, decreased ROM, and TTP of MCP joint
- Assess for rotational alignment (rotational malalignment is not tolerated)
- Assess for skin integrity (rule out fight bite)
Imaging
- AP, lateral, oblique
- Angulation assessed on lateral view
- Consider "Brewerton view (X-Ray)" if collateral ligament avulsion fracture suspected
Differential Diagnosis
Hand and Finger Fracture Types
Management
- Ulnar Gutter Splint or Short arm cast that extends to the PIP joint
- In a comparison of the typical 4th and 5th digit flexed at the MCP joint and a short arm, there was no significant benefit to the intrinsic plus position of the fingers[1]
Disposition
- Almost always refer b/c are intraarticular and typically comminuted
- Non-displaced fracture can be splinted for 2-3 weeks followed by ROM exercises