From the Research
Treatment Options for Proximal 5th Metacarpal Fracture
- The treatment for a proximal 5th metacarpal fracture can vary depending on the severity and displacement of the fracture 1, 2, 3, 4, 5.
- Conservative treatment is often recommended for non-displaced or minimally displaced fractures, with the goal of achieving anatomic and stable reduction, bony union, and early mobilization to minimize disability 1, 4, 5.
- For displaced fractures, surgical treatment may be necessary to restore the bony shape and articular surface, with options including closed reduction and percutaneous pinning, open reduction with multiple Kirschner pinning, or internal fixation with plates or screws 2, 3, 4, 5.
- The choice of treatment depends on the individual case, taking into account the radiological criteria and clinical extent of displacement, as well as the need to protect soft tissue structures and promote early mobilization 2, 4, 5.
Specific Treatment Recommendations
- For fractures of the base of the fifth metacarpal bone, reduction, restoration of the articular surface, and pinning are recommended as the method of choice 3.
- For boxer's fractures (fifth metacarpal neck fractures), conservative treatment is often recommended, with closed reduction and immobilization, although surgical treatment may be necessary in cases with significant displacement or instability 2, 4.
- Early functional treatment should be carried out in stable, non-displaced fractures, with the use of a cast or twin-tape fixation to allow for functional treatment after soft-tissue swelling has disappeared 4, 5.