In some cases, I use a small metal plate and screws to fix the bones internally. During the surgery I improve the alignment of the fracture and use an implant to stabilize the pieces. The surgery is usually performed on an outpatient basis using regional anesthesia and sedation. The natural tendency of the hand after trauma is to become “stiff.” Once the fracture begins to heal, I recommend that patients start to perform range of motion exercises, usually guided by hand therapy. Reducing or eliminating tobacco will improve your healing potential and decrease your risk of delayed healing nonunion, and infection. If you smoke, this is a good time to quit. I recommend a diet rich in protein and calcium and an adequate intake of calories per day while your body is healing. What can patients do to improve the outcome?Īdequate nutrition is important during the healing and recovery process. Depending on the patient’s health and activity level, surgery may be advised to improve and maintain the alignment of the bones. Some patients have fractures which are more severe and the alignment of the fracture may not be satisfactory. This is composed of new bone formation, the body’s normal response to heal the fractured bone. This can be seen on x-ray and is called the “fracture callus.” A firm “bump” is often noticed at the fracture site during healing. Hand therapy can help to improve finger range of motion and strength. Some fractures can be re-aligned with manipulation (without surgery) called “closed reduction”, and those patients can also be treated non-operatively. Follow-up x-rays are obtained in clinic to evaluate how the fracture is healing. Treatment in these cases is typically rest and protection in a cast or brace for 4-6 weeks. Most people have fractures which are well-aligned, and, therefore, do not require surgery. The treatment plan will depend on the severity of the fracture as noted on the x-rays and the patient’s medical condition, activity level, and desires. “Fracture” is simply the medical term for “broken bone.” The image below demonstrates a shaft fracture of the 5th metacarpal bone. A fracture of the metacarpal neck of the small finger is sometimes called a “boxer’s fracture” as they can be seen in punching injuries. Satisfactory healing of this fracture is important to restoring overall hand function. The metacarpals contribute to the bony architecture of the hand. There are five metacarpals - one for each finger and the thumb. They can occur from a variety of injuries such as a fall, a motor vehicle collision, or punching a wall. Metacarpal fractures are common hand injuries.
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