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Metacarpal Fracture and Dislocation Follow-up

  • Author: David R Steinberg, MD; Chief Editor: Craig C Young, MD  more...
 
Updated: Mar 10, 2015
 

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The patient recovering from a metacarpal fracture and/or dislocation may be able to return to nonstrenuous activities at 6-8 weeks. Unprotected participation in contact sports should be avoided for 3 months.

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Complications

See the list below:

  • Painful or prominent hardware may need to be removed after the metacarpal fracture has fully healed.
  • Angular or rotational malunions that substantially affect hand function may be treated with osteotomy.
  • Nonunions are rare. Patients who desire to avoid surgery can try using external bone-growth stimulators. Definitive treatment usually consists of surgical take-down of the nonunion, followed by stabilization and bone grafting.
  • Posttraumatic arthritis may occur after any intra-articular injury.
    • Conservative treatment consists of joint protection, activity modification, and judicious use of corticosteroid injections.
    • Standard pharmacologic treatment for arthritis may also be considered.
    • Relatively severe cases may require surgery, including osteotomy, arthroplasty, or arthrodesis.
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Prevention

Hand injuries are difficult to completely prevent in active individuals, particularly those involved in high-risk contact sports. Buddy-taping of previously injured fingers may help prevent further fractures and dislocations.

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Prognosis

After an appropriate period for healing and rehabilitation, most patients regain relatively normal use of the hand. Some residual stiffness or weakness is not entirely unusual.

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Contributor Information and Disclosures
Author

David R Steinberg, MD Director of Hand Fellowship, Associate Professor, Department of Orthopedic Surgery, University of Pennsylvania Health System

David R Steinberg, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Society for Surgery of the Hand

Disclosure: Received nothing received, but have long-term ownership of public equities from Johnson & Johnson for none.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Gerard A Malanga, MD Founder and Partner, New Jersey Sports Medicine, LLC and New Jersey Regenerative Institute; Director of Research, Atlantic Health; Clinical Professor, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Fellow, American College of Sports Medicine

Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Institute of Ultrasound in Medicine, North American Spine Society, International Spine Intervention Society, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine

Disclosure: Received honoraria from Cephalon for speaking and teaching; Received honoraria from Endo for speaking and teaching; Received honoraria from Genzyme for speaking and teaching; Received honoraria from Prostakan for speaking and teaching; Received consulting fee from Pfizer for speaking and teaching.

References
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  2. Stern PJ. Fractures of the metacarpals and phalanges. Green DP, Hotchkiss RN, Pederson WC, eds. Green’s Operative Hand Surgery. 4th ed. New York, NY: Churchill Livingstone; 1999. 711-71.

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