Flashcards on Metacarpal and Phalangeal Fractures
Metacarpal & Phalangeal Fractures: Student Study Guide
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Metacarpal fractures: management
127 cards
Card 1
Question: What immediate position and cast type is recommended for displaced metacarpal shaft fractures when treated nonoperatively?
Answer: A well-molded, forearm-based cast extending to the IP joints holding the MP joints in about 60° of flexion, with attention to rotational alignment.
Card 2
Question: How often should radiographic monitoring be done for a metacarpal shaft fracture managed in a cast?
Answer: Weekly radiographic imaging.
Card 3
Question: When can guarded active range-of-motion exercises be started after casting a metacarpal shaft fracture?
Answer: At 3 to 4 weeks.
Card 4
Question: Does marked swelling preclude closed manipulation and casting of acute metacarpal shaft fractures?
Answer: No — marked swelling does not preclude manipulation and casting; the cast should be changed at 5 to 7 days when swelling subsides.
Card 5
Question: When is closed manipulation with percutaneous fixation indicated for metacarpal fractures?
Answer: When the fracture can be reduced but cannot be maintained in plaster, or when concomitant soft-tissue injury requires dressing changes and inspection.
Card 6
Question: What imaging modality is particularly useful during percutaneous reduction and fixation?
Answer: Fluoroscopy.
Card 7
Question: What is the typical percutaneous pinning technique for transverse fractures of the fourth or fifth metacarpal?
Answer: Pin the fractured metacarpal to the neighboring intact metacarpal using two parallel transverse pins into the distal fragment and one through the prox
Card 8
Question: What angulation thresholds indicate open reduction for transverse shaft fractures of the 2nd–5th metacarpals?
Answer: Residual angulation >10° for the 2nd and 3rd metacarpals; 20–30° for the ring (4th) metacarpal; 30–40° for the small (5th) metacarpal.
Card 9
Question: Which fracture patterns nearly always indicate ORIF for metacarpal shafts?
Answer: Spiral and oblique fractures, particularly with rotational deformity; multiple metacarpal fractures; open fractures with soft-tissue injury or bone lo
Card 10
Question: Describe the surgical exposure for ORIF of a metacarpal shaft.
Answer: Longitudinal incision just to one side of the extensor tendon over the involved metacarpal; if all four metacarpals need reduction, use two longitudin