Non-thumb metacarpal fracture (base)
Revision as of 01:01, 3 July 2016 by Neil.m.young (talk | contribs) (Text replacement - "fx " to "fracture ")
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 fracture 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
Disposition
- Refer for:
- Intraarticular fx
- Extraarticular fracture with malrotation
- Dislocation of metacarpal base CMC joint;
- Ulnar nerve injury
- 5th metacarpal base fracture (typically require sx)