Return to Play
The patient recovering from a metacarpal fracture and/or dislocation may be able to return to nonstrenuous activities at 6-8 weeks. Unprotected participation in contact sports should be avoided for 3 months.
Complications
See the list below:
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Painful or prominent hardware may need to be removed after the metacarpal fracture has fully healed.
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Angular or rotational malunions that substantially affect hand function may be treated with osteotomy.
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Nonunions are rare. Patients who desire to avoid surgery can try using external bone-growth stimulators. Definitive treatment usually consists of surgical take-down of the nonunion, followed by stabilization and bone grafting.
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Posttraumatic arthritis may occur after any intra-articular injury.
Conservative treatment consists of joint protection, activity modification, and judicious use of corticosteroid injections.
Standard pharmacologic treatment for arthritis may also be considered.
Relatively severe cases may require surgery, including osteotomy, arthroplasty, or arthrodesis.
Prevention
Hand injuries are difficult to completely prevent in active individuals, particularly those involved in high-risk contact sports. Buddy-taping of previously injured fingers may help prevent further fractures and dislocations.
Prognosis
After an appropriate period for healing and rehabilitation, most patients regain relatively normal use of the hand. Some residual stiffness or weakness is not entirely unusual.
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Displaced fourth and fifth metacarpal fractures, anteroposterior view.
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Displaced fourth and fifth metacarpal fractures, lateral view.
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Fourth and fifth metacarpal fractures, oblique view.
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Fourth and fifth metacarpal fractures after intramedullary pinning, anteroposterior view.
