Fundamentals of Metacarpal Fractures

Metacarpal fractures are 18% of all upper extremity fractures and 36% of hand and wrist fractures; the incidence peaks are in males between 15 and 24 years old. These fractures used to be managed nonoperatively until the twentieth century because they were functionally stable before or after closed reduction and would fare well with protective splinting and early mobilization. However, to have the best treatment, it should be considered the fracture location (intra vs. extra-articular), fracture geometry (transverse, spiral, or oblique, comminuted), deformity (angular, rotational, and shortening), open or closed fracture, associated bones and soft tissue injuries, fracture stability, patients age, occupation, socioeconomic status, presence of systemic illness, and patients’ compliance. This chapter presents the basic concepts of the most frequent metacarpal fractures and their treatment options.