Metacarpal Fracture
Metacarpal fractures are common hand injuries. They can occur from a variety of injuries such as a fall, a motor vehicle collision, or striking the fist against a hard surface. There are five metacarpals, one for each finger and the thumb. The metacarpals contribute to the bony architecture of the hand. Satisfactory healing of this fracture is important to restoring hand function. A very common fracture of the metacarpal neck of the small finger is sometimes called a “boxer’s fracture,” as they can be seen in punching injuries. The metacarpals are the bones which connect the fingers to the carpal bones of the wrist.
What Are the Treatment Options for a Metacarpal Fracture?
The treatment plan will depend on the severity of the fracture and the patient’s medical condition and activity level. Most people have fractures which are well-aligned, and, therefore, do not require surgery and are treated in a splint or cast. Follow-up x-rays are obtained to evaluate how the fracture is healing. Hand therapy is sometimes necessary to improve strength and range of motion.
Some patients with displaced fractures can be treated with manual realignment of the fracture. This is performed in the office or emergency room with local anesthesia (numbing medicine). Once the bones are “set,” a splint is placed to maintain the alignment.
Surgery may be recommended to patients with more severe fractures, such as those with unsatisfactory bone alignment.
What is Metacarpal Fracture Surgery?
The surgery is performed as an outpatient using either regional anesthesia or general anesthesia. During surgery, the bones are realigned and stabilized. In some cases, a low-profile plate and/or screws are used to fix the bones internally. This is called “open reduction and internal fixation” and requires an incision on the back of the hand. In other cases, temporary pins are placed through the skin to stabilize the bones while they heal. This is called “closed reduction and percutaneous pinning.” The pins can be removed in clinic after a few weeks. Other surgical options include intramedullary screw fixation and external fixation. Which technique is used depends on the fracture pattern and is often determined in the operating room.
What Can I Expect After Surgery for a Metacarpal Fracture?
Rest and elevation of the hand above the level of the heart is very import for the first few days after surgery to reduce swelling. The bone healing process takes about 6 weeks, but full hand recovery can take a few months. The doctor and therapists will guide patients to improve their finger range of motion, decrease hand swelling, reduce scar tissue, and improve grip strength gradually as the bone heals.
What Are the Potential Complications of Metacarpal Fracture Surgery?
Possible complications include pain, bleeding, infection, stiffness, nonunion, malunion, hardware failure, and damage to the surrounding nerves and blood vessels. A fracture which fails to unite is known as a nonunion. A fracture which heals with deformity is known as a malunion. Other complications are also possible but are uncommon.
What Can I Do to Improve My Results Following a Metacarpal Fracture Surgery?
Adequate nutrition is important during the healing and recovery process. If you smoke, reducing or eliminating tobacco use will decrease your risk of complications such as delayed healing and infection. Complying with the therapist’s recommendations is very important to maximize your result. The natural tendency of the hand after trauma is to become “stiff” and swollen. Dedication to a hand therapy program can be valuable in reducing the chance of complications and restoring function.
Get Your Metacarpal Fracture Treated Today
A metacarpal fracture can be a setback, but it doesn’t have to define your hand’s future. Our team at Raleigh Hand to Shoulder Center specializes in guiding patients through the metacarpal fracture recovery process and return to function. Call our office today or schedule an appointment online.
Updated 6/21/2025
The material provided on this site is intended for general information only and does not constitute medical advice. This does not replace direct evaluation by a physician.
