Articular fractures of the metacarpal head can usually be treated with screw fixation but require experience. If the articular fragments are sufficiently large, condylar plate fixation is an option.
In simple fractures, if stable after reduction, treatment with a dorsal splint in functional hand position may be possible.
Even if there is a high risk of nonunion or posttraumatic arthritis, ORIF should be considered with arthroplasty or arthrodesis as a salvage procedure.
Fracture-dislocations can be easily missed. Soft-tissue interposition in displaced fractures can interfere with closed reduction.
Articular fractures of the metacarpal head can usually be treated with screw fixation but require experience. If the articular fragments are sufficiently large, condylar plate fixation is an option.
In simple fractures, if stable after reduction, treatment with a dorsal splint in functional hand position may be possible.
Even if there is a high risk of nonunion or posttraumatic arthritis, ORIF should be considered with arthroplasty or arthrodesis as a salvage procedure.
Fracture-dislocations can be easily missed. Soft-tissue interposition in displaced fractures can interfere with closed reduction.
Simple fracture stable after reduction
Contraindications
Disadvantages
Simple fracture stable after reduction
Contraindications
Disadvantages
Unstable avulsion fracture, small articular fragment
Unstable avulsion fracture, small articular fragment
Partial articular fracture with large fragment and articular incongruity
Contraindications
Advantages
Disadvantages
Partial articular fracture with large fragment and articular incongruity
Contraindications
Advantages
Disadvantages
Complete articular fracture with significant articular deformity and joint incongruity, unstable after reduction
Contraindications
Advantages
Disadvantages
Complete articular fracture with significant articular deformity and joint incongruity, unstable after reduction
Contraindications
Advantages
Disadvantages
Complete articular fracture with significant articular deformity and joint incongruity, simple complete articular fractures with large enough fragments, unstable after reduction
Contraindications
Advantages
Disadvantages
Complete articular fracture with significant articular deformity and joint incongruity, simple complete articular fractures with large enough fragments, unstable after reduction
Contraindications
Advantages
Disadvantages
Partial articular fracture with subluxation of the carpometacarpal joint, significant angular or rotational deformity
Further indications
Contraindications
Advantages
Disadvantages
Partial articular fracture with subluxation of the carpometacarpal joint, significant angular or rotational deformity
Further indications
Contraindications
Advantages
Disadvantages
