Update on the Treatment of Metacarpal Fractures
Extra-articular metacarpal base fractures can be treated in a similar fashion to metacarpal shaft fractures depending on the size of the proximal segment. Intraarticular fractures of the second through fifth metacarpals are relatively rare. Bushnell et al. performed a review of several case series in the literature on treatment of second through fifth intraarticular metacarpal base fractures. The review concluded that displaced, intraarticular fractures trended towards improved outcomes with operative management. However, there are several conflicting studies, and approximately 40% of patients with intraarticular metacarpal base fractures experience long-term pain regardless of the method of treatment. Treatment of first metacarpal base fractures is beyond the scope of this paper and will not be discussed.
Metacarpal Base
Extra-articular metacarpal base fractures can be treated in a similar fashion to metacarpal shaft fractures depending on the size of the proximal segment. Intraarticular fractures of the second through fifth metacarpals are relatively rare. Bushnell et al. performed a review of several case series in the literature on treatment of second through fifth intraarticular metacarpal base fractures. The review concluded that displaced, intraarticular fractures trended towards improved outcomes with operative management. However, there are several conflicting studies, and approximately 40% of patients with intraarticular metacarpal base fractures experience long-term pain regardless of the method of treatment. Treatment of first metacarpal base fractures is beyond the scope of this paper and will not be discussed.
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