Davos Courses

Executive Editor: Chris Colton

Authors: Renato Fricker, Matej Kastelec, Fiesky Nuñez, Terry Axelrod

Metacarpals - Shaft, oblique

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Glossary

General considerations

These common fractures are usually best treated with lag screws.

A minimum of two screws must be used, which necessitates that the length of the fracture zone be at least twice the diameter of the metacarpal bone. In case of a shorter fracture line, a single lag screw and a protection plate must be used.

Nonoperative treatment
Main indication Skill Equipment
Stable minimally displaced fractures Basic surgical experience, no specialized skills Basic equipment only

Contraindications

  • Multiple metacarpal fractures
  • Significant displacement or angulation
  • Open fractures
Lag screw with protection plate
Main indication Skill Equipment
Multiple metacarpal fractures, significant displacement or angulation, short obliquity, open fractures Some specialized surgical experience Simple surgical and imaging resources

Contraindications

  • Extensive wound contamination
Lag screw fixation
Main indication Skill Equipment
Multiple metacarpal fractures, significant displacement or angulation, long obliquity, open fractures Some specialized surgical experience Simple surgical and imaging resources

Contraindications

  • Extensive wound contamination
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2008-11-08