1/14/2024 0 Comments First metacarpal fracture splint![]() The hand should be positioned in the intrinsic plus position for splinting: mild wrist extension, 70 to 90 degrees of flexion at MCP joint, and slight flexion at the DIP and PIP joints. Alternatively, a pre-made Galveston splint or a custom orthosis may be used. A Boxer’s fracture should be immobilized with an ulnar gutter splint. Due to the risk of infection from "fight bite," even very small wounds should be thoroughly irrigated, and there should be a low threshold for antibiotic treatment.įor a Boxer’s fracture that is closed, not angulated, and not malrotated or otherwise displaced, splinting is used for initial immobilization. The appropriate treatment for a Boxer’s fracture on initial presentation varies based on whether the fracture is open or closed, the degree of angulation, rotation, and other concomitant injuries. The arteries and nerves supplying the fingers are adjacent to the metacarpal bones and can be injured in severely displaced Boxer’s fractures, requiring surgical intervention. The ligaments are taut in flexion, and more slack in extension, therefore the MCP joints should be splinted in flexion to prevent shortening (intrinsic plus positioning). ![]() The collateral ligaments also join the metacarpal bones to the proximal phalanges and must be taken into consideration during splinting to minimize the risk of loss of motion due to shortening of the ligaments. The interosseous muscles, responsible for adduction and abduction of the fingers, originate from the metacarpal shafts and insert onto proximal phalanges. ![]() Axial load via direct trauma to a clenched fist transfers energy to the metacarpal bone, causing fractures most commonly at the neck, and typically resulting in apex dorsal angulation due in part to the forces exerted by the pull of the interosseous muscles. The metacarpal bone consists of a head (distally located), neck, body, and base (proximally located). The fifth metacarpal is associated with the fifth digit. We’ll provide care that combines technical expertise with compassionate care to help you regain your hand’s strength and mobility.The fifth metacarpal bone is one of the five metacarpal bones of the hand. If you may have broken a bone in your hand, make an appointment for an evaluation today with Mirza Orthopedics. In addition, you may need physical therapy to help restore the strength and range of motion that can lessen after your finger was immobilized. ![]() Your hand may need to be checked from time to time to make sure the joint doesn’t tighten during healing. The fracture may then be immobilized in a cast to protect both the incision and the fracture.Īfter the broken bone has healed, your surgeon may remove the hardware or leave it in place. An orthopedic surgeon can realign the fracture and fix it in place with hardware such as pins and screws. You’ll either be sedated or put under general anesthesia before your surgery. These fingers have a greater range of motion and can more easily compensate for the injury. In addition, if the metacarpal bones that line up with the ring and small fingers are the ones that are slightly deformed, you may not need surgery.
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