Non-thumb metacarpal fracture (shaft) - Revision history

Rossdonaldson1: /* Management */

2019-09-18T02:53:47Z

Management

← Older revision		Revision as of 02:53, 18 September 2019
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	==Management==		==Management==
	*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]		{{General Fracture Management}}

			===Acute Reduction===
	*Acute reduction indicated if there is pseudo-clawing or significant angulation		*Acute reduction indicated if there is pseudo-clawing or significant angulation
	**Closed reduction generally corrects angulation but typically does not restore length		**Closed reduction generally corrects angulation but typically does not restore length

	{{Metacarpal fracture goals}}		{{Metacarpal fracture goals}}

			===Immobilization===
			*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2019-09-18T02:12:36Z

Management

← Older revision		Revision as of 02:12, 18 September 2019
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	==Management==		==Management==
	*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]]		*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]
	*Acute reduction indicated if there is pseudo-clawing or significant angulation		*Acute reduction indicated if there is pseudo-clawing or significant angulation
	**Closed reduction generally corrects angulation but typically does not restore length		**Closed reduction generally corrects angulation but typically does not restore length

Rossdonaldson1: /* Management */

2019-09-18T02:12:24Z

Management

← Older revision		Revision as of 02:12, 18 September 2019
Line 26:		Line 26:
	*Acute reduction indicated if there is pseudo-clawing or significant angulation		*Acute reduction indicated if there is pseudo-clawing or significant angulation
	**Closed reduction generally corrects angulation but typically does not restore length		**Closed reduction generally corrects angulation but typically does not restore length

			{{Metacarpal fracture goals}}

	==Disposition==		==Disposition==

Rossdonaldson1 at 11:10, 16 October 2016

2016-10-16T11:10:04Z

← Older revision		Revision as of 11:10, 16 October 2016
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	==Background==		==Background==
	*Extensor tendons and the FDS attach to the middle phalanx		*Extensor tendons and the FDS attach to the middle phalanx<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>
	*Commonly will have volar angulation due to interosseous muscles and extensor tendon attachments		*Commonly will have volar angulation due to interosseous muscles and extensor tendon attachments<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>

	==~~Examination~~==		==Clinical Features==
	*TTP along affected metacarpal		*TTP along affected metacarpal
	*Flexion at MCP is difficult		*Flexion at MCP is difficult

			==Differential Diagnosis==
			{{Hand and finger fractures DDX}}

			==Evaluation==
			===Imaging===
			*Hand x-rays
			**Oblique fracture are more prone to shorten and rotate
			**Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fracture)

			===Physical===
	*Assess for extensor dysfunction; patient may exhibit "pseudo-clawing" during attempts at finger extension		*Assess for extensor dysfunction; patient may exhibit "pseudo-clawing" during attempts at finger extension
	*Assess angulation		*Assess angulation
	**>10 deg in 2nd and 3rd and >20 deg in 4th and 5th metacarpal shaft fractures requires reduction		**>10 deg in 2nd and 3rd and >20 deg in 4th and 5th metacarpal shaft fractures requires reduction
	*Assess rotational alignment		*Assess rotational alignment

	~~==Imaging==~~
	*Oblique fracture are more prone to shorten and rotate
	*Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fracture)

	~~==Differential Diagnosis==~~
	~~{{Hand and finger fractures DDX}}~~

	==Management==		==Management==
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	==References==		==References==
	<references/>		<references/>
	*German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.

	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Ted Fan: added background

2016-10-11T13:39:26Z

added background

← Older revision		Revision as of 13:39, 11 October 2016
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			==Background==
			*Extensor tendons and the FDS attach to the middle phalanx
			*Commonly will have volar angulation due to interosseous muscles and extensor tendon attachments

	==Examination==		==Examination==
	*TTP along affected metacarpal		*TTP along affected metacarpal
Line 33:		Line 37:
	==References==		==References==
	<references/>		<references/>
			*German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.

	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Rossdonaldson1: Text replacement - "fx" to "fracture"

2016-07-08T10:16:22Z

Text replacement - "fx" to "fracture"

← Older revision		Revision as of 10:16, 8 July 2016
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	==Imaging==		==Imaging==
	*Oblique fracture are more prone to shorten and rotate		*Oblique fracture are more prone to shorten and rotate
	*Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fx)		*Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fracture)

	==Differential Diagnosis==		==Differential Diagnosis==

Neil.m.young: Text replacement - "==Treatment==" to "==Management=="

2016-07-07T18:03:33Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 18:03, 7 July 2016
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	{{Hand and finger fractures DDX}}		{{Hand and finger fractures DDX}}

	==~~Treatment~~==		==Management==
	*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]]		*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]]
	*Acute reduction indicated if there is pseudo-clawing or significant angulation		*Acute reduction indicated if there is pseudo-clawing or significant angulation

Neil.m.young: Text replacement - "* " to "*"

2016-07-04T12:14:37Z

Text replacement - "* " to "*"

← Older revision		Revision as of 12:14, 4 July 2016
Line 1:		Line 1:
	==Examination==		==Examination==
	* TTP along affected metacarpal		*TTP along affected metacarpal
	* Flexion at MCP is difficult		*Flexion at MCP is difficult
	* Assess for extensor dysfunction; patient may exhibit "pseudo-clawing" during attempts at finger extension		*Assess for extensor dysfunction; patient may exhibit "pseudo-clawing" during attempts at finger extension
	* Assess angulation		*Assess angulation
	** >10 deg in 2nd and 3rd and >20 deg in 4th and 5th metacarpal shaft fractures requires reduction		**>10 deg in 2nd and 3rd and >20 deg in 4th and 5th metacarpal shaft fractures requires reduction
	* Assess rotational alignment		*Assess rotational alignment

	==Imaging==		==Imaging==
	* Oblique fracture are more prone to shorten and rotate		*Oblique fracture are more prone to shorten and rotate
	* Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fx)		*Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fx)

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Treatment==		==Treatment==
	*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]]		*[[Ulnar Gutter Splint]] or [[Radial Gutter Splint]]]
	* Acute reduction indicated if there is pseudo-clawing or significant angulation		*Acute reduction indicated if there is pseudo-clawing or significant angulation
	** Closed reduction generally corrects angulation but typically does not restore length		**Closed reduction generally corrects angulation but typically does not restore length

	==Disposition==		==Disposition==
	* Refer:		*Refer:
	** Malrotation		**Malrotation
	** Comminution		**Comminution
	** Shortening > 5mm (refer all shortening if not familiar with fracture management)		**Shortening > 5mm (refer all shortening if not familiar with fracture management)
	** 2 or more metacarpal fractures		**2 or more metacarpal fractures
	** Unacceptable angulation		**Unacceptable angulation
	** Long oblique fractures		**Long oblique fractures

	==See Also==		==See Also==

Neil.m.young: Text replacement - "fx " to "fracture "

2016-07-03T04:34:34Z

Text replacement - "fx " to "fracture "

← Older revision		Revision as of 04:34, 3 July 2016
Line 8:		Line 8:

	==Imaging==		==Imaging==
	* Oblique fx are more prone to shorten and rotate		* Oblique fracture are more prone to shorten and rotate
	* Transverse fx generally stable (particularly isolated 3rd or 4th MC shaft fx)		* Transverse fracture generally stable (particularly isolated 3rd or 4th MC shaft fx)

	==Differential Diagnosis==		==Differential Diagnosis==
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	** Malrotation		** Malrotation
	** Comminution		** Comminution
	** Shortening > 5mm (refer all shortening if not familiar with fx management)		** Shortening > 5mm (refer all shortening if not familiar with fracture management)
	** 2 or more metacarpal fractures		** 2 or more metacarpal fractures
	** Unacceptable angulation		** Unacceptable angulation

Neil.m.young: Text replacement - " pt " to " patient "

2016-07-01T20:20:13Z

Text replacement - " pt " to " patient "

← Older revision		Revision as of 20:20, 1 July 2016
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	* TTP along affected metacarpal		* TTP along affected metacarpal
	* Flexion at MCP is difficult		* Flexion at MCP is difficult
	* Assess for extensor dysfunction; pt may exhibit "pseudo-clawing" during attempts at finger extension		* Assess for extensor dysfunction; patient may exhibit "pseudo-clawing" during attempts at finger extension
	* Assess angulation		* Assess angulation
	** >10 deg in 2nd and 3rd and >20 deg in 4th and 5th metacarpal shaft fractures requires reduction		** >10 deg in 2nd and 3rd and >20 deg in 4th and 5th metacarpal shaft fractures requires reduction