Non-thumb metacarpal fracture (head): Difference between revisions
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{{Hand and finger fractures DDX}} | {{Hand and finger fractures DDX}} | ||
== | ==Management== | ||
*[[Ulnar Gutter Splint]] or Short arm cast that extends to the PIP joint | *[[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<ref>http://dx.doi.org/10.1016/j.jhsa.2008.04.010.</ref> | **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<ref>http://dx.doi.org/10.1016/j.jhsa.2008.04.010.</ref> | ||
Revision as of 09:08, 8 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 (r/o 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