Metacarpal and Phalangeal Fractures



10.1055/b-0034-97738

Metacarpal and Phalangeal Fractures

Aaron Mull & Amy M. Moore
A 28-year-old left hand-dominant man presents with hand pain after striking someone with his left hand. The X-ray is shown above. On examination, overlapping of the patient′s ring and small fingers is noted while he makes a fist.


Description




  • Oblique extra-articular fracture of ring finger metacarpal shaft with angulation, rotation, and shortening,



Work-up



History




  • Mechanism of injury (e.g., sharp, blunt, avulsion).



  • Time elapsed since injury.



  • Possible contamination during injury (e.g., oral contamination, farm injury).



  • Hand dominance.



  • Occupation.



  • Smoking status.



  • Inquire about prior hand injuries or operations.



Physical examination




  • Assess for skin lacerations/injury, degree of contamination, and viability of soft tissues.



  • Examine for possibility of open fractures and joint involvement.



  • Assess for angulation and rotation of digit while the patient makes a fist (i.e., scissoring).



  • Assess for neurovascular integrity of the affected digits.

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Jun 18, 2020 | Posted by in General Surgery | Comments Off on Metacarpal and Phalangeal Fractures
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