Non-thumb metacarpal fracture (shaft): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - " pt " to " patient ") |
Neil.m.young (talk | contribs) (Text replacement - "fx " to "fracture ") |
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==Imaging== | ==Imaging== | ||
* Oblique | * Oblique fracture are more prone to shorten and rotate | ||
* Transverse | * Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fx) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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** Malrotation | ** Malrotation | ||
** Comminution | ** Comminution | ||
** Shortening > 5mm (refer all shortening if not familiar with | ** Shortening > 5mm (refer all shortening if not familiar with fracture management) | ||
** 2 or more metacarpal fractures | ** 2 or more metacarpal fractures | ||
** Unacceptable angulation | ** Unacceptable angulation | ||
Revision as of 04:34, 3 July 2016
Examination
- TTP along affected metacarpal
- Flexion at MCP is difficult
- Assess for extensor dysfunction; patient 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 fracture are more prone to shorten and rotate
- Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fx)
Differential Diagnosis
Hand and Finger Fracture Types
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
Disposition
- Refer:
- Malrotation
- Comminution
- Shortening > 5mm (refer all shortening if not familiar with fracture management)
- 2 or more metacarpal fractures
- Unacceptable angulation
- Long oblique fractures