Non-thumb metacarpal fracture
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Non-thumb metacarpal fracture (head)
Non-thumb metacarpal fracture (neck)
Non-thumb metacarpal fracture (shaft)
Non-thumb metacarpal fracture (base)
Examination
- Movement at the wrist elicits pain
- Assess for ulnar deficits (finger abduction/adduction)
- Assess for rotational alignment
Imaging
- AP, lateral, oblique
- 30 deg obliques pronated and supinated if usual films unable to visualize the MC bases
- Consider CT if index of suspicion high for occult fx despite "negative" plain films
Differential Diagnosis
Hand and Finger Fracture Types
Treatment
- Dorsal and Forearm Volar Splint with the wrist in 30 deg of extension and MCP joints free
Dispo
- Refer for:
- Intraarticular fx
- Extraarticular fx with malrotation
- Dislocation of metacarpal base CMC joint;
- Ulnar nerve injury
- 5th metacarpal base fx (typically require sx)