Non-thumb metacarpal fracture: Difference between revisions

Revision as of 08:12, 10 January 2015

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

Dorsal and Forearm Volar Splint‎ with the wrist in 30 deg of extension and MCP joints free

Authors:

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 ==[[Non-thumb metacarpal fracture (neck)]]==
 ==[[Non-thumb metacarpal fracture (shaft)]]==
-===Examination===
-* TTP along affected metacarpal
-* Flexion at MCP is difficult
-* Assess for extensor dysfunction; pt 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 fx are more prone to shorten and rotate
-* Transverse fx generally stable (particularly isolated 3rd or 4th MC shaft fx)
-==Differential Diagnosis==
-{{Hand and finger fractures DDX}}
-===Treatment===
-*[[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
-===Dispo===
-* Refer:
-** Malrotation
-** Comminution
-** Shortening > 5mm (refer all shortening if not familiar with fx management)
-** 2 or more metacarpal fractures
-** Unacceptable angulation
-** Long oblique fractures
 ==[[Non-thumb metacarpal fracture (base)]]==
 ===Examination===