Executive Editor: Chris Colton

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

Metacarpals

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Glossary

Head, subcapital

Please select a treatment option:
Treatment Main indication Skill Equipment
Intramedullary K-wire fixation Significant angular deformity, rotational deformity Some specialized surgical experience Basic equipment only

Head, intraarticular

Please select a treatment option:
Treatment Main indication Skill Equipment
Screw fixation Significant articular deformity Highly experienced and skilled surgeon Simple surgical and imaging resources

Shaft, oblique

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Stable minimally displaced fractures Basic surgical experience, no specialized skills Basic equipment only
Lag screw with protection plate Multiple metacarpal fractures, significant displacement or angulation, short obliquity, open fractures Some specialized surgical experience Simple surgical and imaging resources
Lag screw fixation Multiple metacarpal fractures, significant displacement or angulation, long obliquity, open fractures Some specialized surgical experience Simple surgical and imaging resources

Shaft, transverse

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Stable minimally displaced fractures Basic surgical experience, no specialized skills Basic equipment only
Compression plate fixation Multiple metacarpal fractures, significant displacement or angulation, open fractures Basic surgical experience, no specialized skills Basic equipment only

Shaft, multifragmentary

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative treatment Well aligned, minimally displaced, low functional demand patient Basic surgical experience, no specialized skills Basic equipment only
Bridge plate fixation Shortening, angulation, rotational deformity, open fractures Some specialized surgical experience Simple surgical and imaging resources

Base fracture

Please select a treatment option:
Treatment Main indication Skill Equipment
Plate fixation Fracture subluxation of the carpo-metacarpal joint, significant angular or rotational deformity Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Special considerations

Principles of management of open fractures
Complications
Infection
Compartment syndrome
*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