Broken Metacarpal Treatments

Introduction to Broken Metacarpals: Causes and Symptoms

A broken metacarpal, or metacarpal fracture, is a common injury that can occur due to various causes such as direct trauma, sports accidents, or falls. It involves the breaking or cracking of one or more of the metacarpal bones in the hand. 

Symptoms of a broken metacarpal typically include pain, swelling, deformity, difficulty in moving the hand, and tenderness. Understanding the causes, diagnosis, and treatment options is crucial for effective management and recovery.

Anatomy of the Hand: Understanding the Injury

To better comprehend the impact of a broken metacarpal, it’s essential to understand the hand’s anatomy. The hand consists of five metacarpal bones, which connect the wrist to the fingers. Each metacarpal bone is composed of a base, shaft, and head. Fractures can occur in any of these metacarpal bones, and the specific location and severity of the fracture influence the treatment approach.

Diagnosis of a Broken Metacarpal: Imaging and Examination

If a broken metacarpal is suspected, seeking immediate medical attention is crucial. A hand surgeon will conduct a thorough examination, assessing the symptoms and performing imaging tests to confirm the diagnosis and determine the extent of the fracture. X-rays are commonly used to obtain detailed images of the metacarpal bones.

Non-Surgical Treatments for a Broken Metacarpal

In many cases, non-surgical treatments can effectively manage and promote healing of broken metacarpals, especially for stable fractures.

Immobilization: Splints and Casts

One of the primary treatment approaches for a broken metacarpal is immobilization. The hand is immobilized using a splint or cast to keep the bones in proper alignment while they heal. The duration of immobilization depends on the type and severity of the fracture.

Pain Management: Medications and Natural Remedies

To alleviate pain and discomfort associated with a broken metacarpal, healthcare providers may recommend pain medications. Over-the-counter pain relievers can be effective, and natural remedies such as applying ice packs or using herbal ointments may provide additional relief.

Surgical Treatments for a Broken Metacarpal

In certain cases, surgery may be necessary to ensure proper alignment and healing of a broken metacarpal, particularly for more complex or unstable fractures.

Indications for Surgery

Surgery is typically recommended when the fracture is severe, significantly displaced, involves the joint, or when non-surgical treatments fail to achieve proper alignment. The decision for surgery depends on various factors, including the specific metacarpal bone affected, the degree of displacement, and the individual patient’s needs.

Different Surgical Procedures for Metacarpal Fractures

Several surgical procedures may be employed to treat broken metacarpals, depending on the nature and complexity of the fracture. Common surgical interventions include:

1. Open Reduction and Internal Fixation (ORIF): This procedure involves making an incision to access the fractured metacarpal bone. The surgeon then repositions the bone fragments into their proper alignment and uses screws, plates, or wires to stabilize them.
2. Closed Reduction and Percutaneous Pinning: In this technique, the hand surgeon manually realigns the fractured metacarpal bone without making an incision. Small pins or wires are inserted through the skin and into the bone to hold the fragments in place during the healing process.
3. External Fixation: This surgical technique involves the use of an external device to stabilize the fractured metacarpal bone. Metal pins or wires are inserted through the skin and into the bone, and these pins or wires are connected to an external frame outside the body, providing stability and promoting proper healing.
4. Intramedullary Fixation: In this procedure, a specially designed metal rod is inserted into the medullary canal (the hollow center) of the fractured metacarpal bone. The rod acts as an internal splint, providing stability and facilitating bone healing.
5. Bone Grafting: When there is a significant loss of bone or a non-healing fracture, a bone graft may be necessary. This procedure involves taking bone tissue from another part of the body (autograft) or using donor bone (allograft) to fill in the gaps and promote bone healing.
6. Percutaneous Fixation: This minimally invasive technique involves the use of small pins or screws inserted through the skin and into the fractured metacarpal bone. The pins or screws provide stability and facilitate bone healing.
7. Miniature Fragment Plate Fixation: In this procedure, small plates specifically designed for metacarpal fractures are used to stabilize the fractured bone. The plates are secured to the bone using screws, providing stability and promoting proper healing.

It’s important to note that the choice of surgical procedure depends on various factors, including the specific type and location of the metacarpal fracture, the degree of displacement, and your individual needs. 

The treating orthopedic hand surgeon will determine the most appropriate surgical approach based on these factors and the individual patient’s condition.

Rehabilitation and Exercises for a Broken Metacarpal

After the initial healing phase, rehabilitation and exercises play a crucial role in restoring hand function, strength, and mobility.

A hand therapist will work closely with the patient, developing a customized rehabilitation plan. This may include exercises to improve range of motion, strength, and flexibility of the hand. The therapist may also incorporate functional activities to enhance coordination and dexterity. It’s important to follow the therapist’s instructions and attend all scheduled rehabilitation sessions to achieve optimal recovery.

Tips for Speedy Recovery from a Metacarpal Fracture

To facilitate a speedy recovery and ensure optimal healing of a broken metacarpal, consider the following tips:

• Adhere to the recommended treatment plan provided by your healthcare provider.
• Keep the hand immobilized as instructed and avoid activities that may cause further injury.
• Take prescribed pain medications as directed to manage discomfort.
• Attend all scheduled rehabilitation sessions and diligently perform prescribed exercises.
• Maintain good overall health by following a balanced diet, getting adequate rest, and avoiding activities that put unnecessary strain on the hand.

Prevention: Reducing the Risk of Hand Injuries

While it may not be possible to prevent all hand injuries, you can take precautions to reduce the risk:

• Use protective gear: Wear appropriate gloves or hand guards during activities that pose a higher risk of hand injury, such as sports or manual labor.
• Practice proper technique: When participating in sports or performing physical tasks, ensure you are using the correct technique to minimize the strain on your hands.
• Maintain a safe environment: Keep walkways clear of obstacles, maintain proper lighting, and be cautious of slippery surfaces to avoid falls that could lead to hand injuries.
• Take breaks and rest: If you engage in repetitive activities that strain the hands, take regular breaks to give your hands a chance to rest and recover.
• Strengthen your hands: Perform exercises that specifically target hand and finger strength and flexibility to help prevent injuries.

Do You Think You’ve Broken a Metacarpal?

Understanding the causes, diagnosis, and treatment options for broken metacarpals is crucial for effective management and recovery. 

Non-surgical treatments, such as immobilization and pain management, are often effective, while surgical interventions may be necessary for more complex or unstable fractures. Rehabilitation and exercises play a vital role in restoring hand function and strength. By taking preventive measures and practicing hand safety techniques, you can reduce the risk of hand injuries and maintain optimal hand health. 

If you suspect a broken metacarpal, seek prompt medical attention and consult a hand surgeon such as Dr. Mark E. Pruzansky or Dr. Jason S. Pruzansky at HandSport Surgery Institute for an accurate diagnosis and appropriate treatment plan.