Metacarpal Fractures

This chapter presents a case scenario of an adult 22-year-old male who injures his dominant right hand in a bicycle accident. Many patients with metacarpal neck fractures do well with nonsurgical treatment. A wide variety of fixation methods can be used to treat metacarpal neck fractures including percutaneous pinning, intramedullary fixation, and open reduction internal fixation with plating. Nonsurgical and surgical treatment for metacarpal neck fractures result in similar patient reported outcomes, grip strength, and range of motion. Some surgeons advocate surgical intervention for angulated small finger metacarpal neck fractures based on the idea that a metacarpal neck fracture that heals in an angulated position interferes with hand function. Nonsurgical and surgical treatment for metacarpal neck fractures result in similar patient reported outcomes, grip strength and range of motion. The chapter also provides recommendations for implementing evidence-based practice in the clinical setting.