![]() At that point, most patients can begin gentle wrist and finger range of motion with the oversight of a hand therapist. ![]() The splint will be removed in clinic after a few days and a removable splint will be provided. Your wrist and fingers will be protected in a plaster splint after the surgery. These medications should be weaned as the pain subsides. The first few days after surgery can be painful, and medications will be prescribed to help. Shoulder and elbow range of motion exercises are important to help prevent stiffness in these joints. Rest and elevation of the hand above the level of the heart is very import for the first few days after surgery to reduce swelling. The bone healing process takes about 6 weeks, but full recovery can take a few months. Which technique is used depends on the fracture pattern and is often determined in the operating room. Other options which are less commonly used include intramedullary nail fixation and external fixation. This is called “closed reduction and percutaneous pinning.” The pins can be removed in clinic after a few weeks. In other cases, temporary pins are placed through the skin to stabilize the bones while they heal. This is called “open reduction and internal fixation” and requires an incision on the back of the hand. In some cases, a low-profile plate and/or screws are used to fix the bones internally. During surgery, the bones are realigned and stabilized. The surgery is performed as an outpatient using either regional anesthesia or general anesthesia. Surgery may be recommended to patients with more severe fractures, such as those with unsatisfactory alignment. Once the bones are “set,” a splint is placed to maintain the alignment. This is performed in the office or emergency room with local anesthesia (numbing medicine). Some patients with displaced fractures can be treated with manual realignment of the fracture. Hand therapy is sometimes necessary to improve strength and range of motion. Follow-up x-rays are obtained to evaluate how the fracture is healing. Most people have fractures which are well-aligned, and, therefore, do not require surgery and are treated in a splint or cast. The treatment plan will depend on the severity of the fracture and the patient’s medical condition and activity level. A fracture of the metacarpal neck of the small finger is sometimes called a “boxer’s fracture,” as they can be seen in punching injuries. Satisfactory healing of this fracture is important to restoring hand function. The metacarpals contribute to the bony architecture of the hand. There are five metacarpals, one for each finger and the thumb. They can occur from a variety of injuries such as a fall, a motor vehicle collision, or striking the fist against a hard surface. Metacarpal fractures are common hand injuries.
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