Overview
What are metacarpal fractures?
What is the anatomy relevant to metacarpal fractures?
What anatomy is relevant to fractures of the fifth metacarpal?
What is the anatomy of the metacarpophalangeal (MCP) joints relevant to metacarpal fractures?
What is the pathophysiology of metacarpal base injuries?
What is the pathophysiology of metacarpal fractures of the shaft or neck?
What is the pathophysiology of metacarpal head injuries?
What is the pathophysiology of metacarpophalangeal dislocations?
What causes metacarpal fractures?
What is the prevalence of metacarpal fractures?
What is the prognosis of metacarpal fractures?
How does the prognosis of metacarpal fractures vary by treatment?
Presentation
Which clinical history is characteristic of metacarpal base fractures?
Which clinical history is characteristic of metacarpal shaft and neck factures?
Which clinical history is characteristic of metacarpal head fractures?
Which clinical history is characteristic of metacarpophalangeal dislocations?
Workup
What is the role of radiography in the diagnosis of metacarpal fractures?
What is the role of imaging studies in the diagnosis of carpometacarpal fractures?
What is the role of imaging studies in the diagnosis of metacarpal head fractures?
How are metacarpophalangeal dislocations diagnosed?
Treatment
What are the treatment options for metacarpal fractures?
What are the treatment options for fractures and dislocations of metacarpal base?
What are the treatment options for fractures on the metacarpal shaft?
What are the treatment options for fractures of metacarpal neck?
What are the treatment options for fractures and dislocations of metacarpal head?
What is included in nonsurgical treatment of metacarpal fractures and dislocations?
How should metacarpal fractures be immobilized?
What is included in nonsurgical treatment of metacarpal base fractures?
What is included in nonsurgical treatment of metacarpal shaft fractures?
What is included in the nonsurgical treatment of metacarpal neck fractures?
What is included in the nonsurgical treatment of metacarpal head fractures?
What is included in the nonsurgical treatment of metacarpophalangeal dislocations?
When is surgery indicated for the treatment of metacarpal fractures?
What is included in preoperative planning for metacarpal fracture surgery?
What is the role of surgery in the treatment of carpometacarpal fractures?
What is the role of surgery in the treatment of metacarpal shaft fractures?
What surgical intervention is used for transverse metacarpal shaft fractures?
Which surgical procedure is used for short oblique fractures in the metacarpal shaft?
Which surgical procedure is used for long oblique or spiral fractures in the metacarpal shaft?
Which surgical procedure is used for comminuted fractures in the metacarpal shaft?
Which surgical procedures are used for metacarpal neck fractures?
Which surgical procedures are used for metacarpal head fractures?
Which procedures are used for comminuted fractures in the metacarpal head?
Which surgical procedures are used for metacarpophalangeal dislocations?
What is included in postoperative care of metacarpal fractures?
What are possible complications of the treatment of metacarpal fractures?
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AP radiograph of displaced 4th and 5th metacarpal fractures.
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Lateral radiograph of displaced 4th and 5th metacarpal fractures.
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Oblique radiograph of 4th and 5th metacarpal fractures.
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AP radiograph of 4th and 5th metacarpal fractures following intramedullary pinning.
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Lateral radiograph of 4th and 5th metacarpals following intramedullary pinning.
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Complex 2nd metacarpophalangeal (MCP) dislocation in skeletally immature patient; note position of finger and dimpling of skin on volar hand.
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Radiograph of complex 2nd metacarpophalangeal (MCP) dislocation in skeletally immature patient (same patient as in Image 6).