Undisplaced, or minimally displaced, fractures of the metacarpal shaft can
be treated nonoperatively.
Most of these fractures produce a flexion deformity and often minimal
shortening. If the flexion deformity exceeds 10-20 degrees in fractures of the
second and third metacarpals, or 20-30 degrees in fractures of the fourth and
fifth metacarpals, ORIF is recommended. Shortening of less than 2 mm does not
interfere with function, but more than 5 mm can not be accepted.