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Adult Metacarpal Shaft Fractures

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Pediatric and Adult Hand Fractures

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Abstract

Metacarpal fractures are some of the most common upper-extremity fractures that occur in adults. In general, metacarpal shaft fractures occur in four configurations: transverse, short oblique, long oblique, and comminuted. Most of these fractures can be successfully treated via nonoperative management. While “absolute” indications for operative management are limited, there are many relative indications that favor operative fixation of metacarpal shaft fractures. These indications range from patient preferences/comorbidities to significant fracture deformity. This chapter reviews the basics of metacarpal anatomy and the physiology of the carpometacarpal and metacarpophalangeal articulations. It also covers the pathoanatomy and pathophysiology of metacarpal fractures. With this basic understanding, we review the indications and most common techniques for both nonoperative and operative management of metacarpal shaft fractures as well as their outcomes. This chapter also emphasizes the use of intramedullary screws in metacarpal shaft fractures, a promising new technique in hand surgery. The goal of this chapter is to provide all hand surgeons with the basic information needed to manage the majority of metacarpal shaft fractures that they will encounter.

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Authors and Affiliations

  1. Orthocarolina Hand Center, OrthoCarolina, Charlotte, NC, USA

    R. Christopher Chadderdon

  2. Atrium Health, Department of Orthopaedic Surgery, Charlotte, NC, USA

    R. Christopher Chadderdon

  3. Orthopaedic Residency, Atrium Health Carolinas Medical Center, Charlotte, NC, USA

    Alexander A. Hysong

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Correspondence to R. Christopher Chadderdon .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Joshua M. Abzug

  2. Atrium Health Carolinas Medical Center, Charlotte, NC, USA

    R. Glenn Gaston

  3. Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    A. Lee Osterman

  4. Rothman Orthopaedic Institute Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

    Richard J. Tosti

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Chadderdon, R.C., Hysong, A.A. (2023). Adult Metacarpal Shaft Fractures. In: Abzug, J.M., Gaston, R.G., Osterman, A.L., Tosti, R.J. (eds) Pediatric and Adult Hand Fractures. Springer, Cham. https://doi.org/10.1007/978-3-031-32072-9_12

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