eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

Metacarpal Fractures: Follow-up

Author: T Michael Dye, MD, Orthopedic Surgeon, Surgical Critical Care Element Chief, Department of Orthopedic Surgery, Eglin Air Force Base
Contributor Information and Disclosures

Updated: Sep 2, 2009

Outcome and Prognosis

Overall, results of treatment of metacarpal shaft and neck fractures have been very good. Nonunion is very rare, but malunion is common. The resultant function despite malunion usually is good, provided there is no rotational deformity and the previously mentioned limits of angular deformity are adhered to.

Future and Controversies

Bioresorbable implants are being used more frequently for fixation of fractures. Biomechanical testing of polyglycolic acid (PGA) and poly–L-lactic acid (PLLA) plates compare favorably in rigidity to titanium but are inferior in torsional testing. Self-reinforced PGA rods used in place of K-wires for intramedullary fixation have an initial bending stiffness of only 60% of stainless-steel wires. When subjected to saline bath, PGA rods lose stability within 4 weeks.

New techniques and equipment may make these implants more cost-effective, and their use precludes the need for implant removal at a second operation.

Further development of low-profile implants may allow more rigid fixation for certain problem fractures, thereby minimizing postoperative stiffness and perhaps diminishing the need for metal removal.

 


More on Metacarpal Fractures

Overview: Metacarpal Fractures
Workup: Metacarpal Fractures
Treatment: Metacarpal Fractures
Follow-up: Metacarpal Fractures
Multimedia: Metacarpal Fractures
References
Further Reading
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References

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Keywords

metacarpal fracture, boxer's fracture, Bennett fracture, reverse Bennett's fracture, carpometacarpal dislocation, metacarpophalangeal dislocation

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Contributor Information and Disclosures

Author

T Michael Dye, MD, Orthopedic Surgeon, Surgical Critical Care Element Chief, Department of Orthopedic Surgery, Eglin Air Force Base
T Michael Dye, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, and Special Operations Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Michael S Clarke, MD, Clinical Associate Professor, Department of Orthopedic Surgery, University of Missouri-Columbia School of Medicine
Michael S Clarke, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, American Association for Hand Surgery, American College of Surgeons, American Medical Association, Arthroscopy Association of North America, Clinical Orthopaedic Society, Mid-Central States Orthopaedic Society, and Missouri State Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

N Ake Nystrom, MD, PhD, Associate Professor of Orthopedic Surgery and Plastic Surgery, University of Nebraska Medical Center
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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