Causes, treatment and recovery after a fracture of the metacarpal bone

The metacarpus is a small tubular bone of the human skeleton, which is located on the wrist. There are five of them in their hand. The metacarpals are counted from the large one and finish by the little finger.

Fracture of the metacarpal bone is a violation of its integrity, partial or complete damage resulting from the mechanical treatment of the hand.

Inaccurate stroke of the hand and injury is provided by

Very often the causes of fracture of metacarpals are:

• various household injuries ( falling of heavy objects on hands, sharp pinching);
• sport ( blow to the pear or opponent during hand-to-hand combat, excessive diligence in training);
• criminal ( during fights and quarrels).

This type of injury is also called "fracture brawler" because of the habit of some people too much, in a fit of quarrel, to tap the palm of hard objects or to hit them with their fists, expressing their anger - it's so easy to get a fracture of the metacarpal bone.

Varieties of fracture

In order to determine the type of fracture of the metacarpal bone, doctors use several types of classification. By the nature of the injury:

1. Open - the skin is damaged along with the bone. Often the bone fragment sticks out.
2. Closed - the fracture is under the skin, its integrity is not compromised.
3. Splintered are the most dangerous fractures. Can be both open and closed. Characterized by a violation of the integrity of the bone with the breaking off of it one or more debris.

By the number of damages:

• single - not more than one;
• multiple - more than one fracture.

In form and direction:

• oblique;
• angled;
• rotary;
• screw-type.

If possible bone dislocation fracture of metacarpal bone happens:

• without bias - broken bones, despite the appearance of a fracture, remain in the same anatomical position;
• with displacement - change of position of bone fragments relative to each other.

At the location of the injured area:

• at the head ( in the region of the metacarpophalic movable joint of bones);
• at the base of the ( near the wrist);
• in the central part of the bone .

Depending on the type of fracture, treatment and methods of fixing the damaged brush will be prescribed.

Fracture of I metacarpal bone

The most common injury of this class is a fracture of the first metacarpal bone. This bone is involved in the opposition and movements of the thumb and most often moves.

Doctors-specialists distinguish two types of this injury.

Bennett fracture

Localized at the base of the bone, occurs when the triangular fragment is injured from the elbow side without changing the location.

The peripheral part of the bone is bent to the radial side, thus both a dislocation and a fracture occur simultaneously. Outside, the characteristic deformities of the finger are seen at the site of the source of the injury.

Occurs as a result of mechanical action on the axis of the thumb, impact or fall of a heavy object. The patient can complain of pain in the area of ​​trauma and restriction of motor activity, finger pulling out because of the intensity of sensations is almost impossible. Attempts to probe this place are very painful.

Fracture without dislocation

Fracture without dislocation is located at a slight distance from the slit of the movable joint. It is called "flexor".It is formed by sharp bending of the metacarpal bone in the palm of the hand, most often due to the impact of a hard object.

Fragments change their position in the inner palmar part. The symptoms are the same as those of Bennett's fracture, the difference in the definition is only in establishing the fact that the carpometacarpal joint was not dislocated.

Such pathologies are often characteristic of athletes, people whose profession is associated with carrying heavy loads or those who are used to solving conflicts in fights.

Injuries are characterized by swelling, swelling, sometimes pathological mobility and unpleasant cracking of the bone.

Injury of II-V metacarpal bones

Injuries can be very different in character, the line of bone fracture, the number of damaged areas, since tubular bones are capable of breaking absolutely anywhere, depending on the localization of the deforming mechanical action.

Fracture with the second to fifth metacarpal bone is much less common than the injury of the first. This trauma requires immediate help and increased attention of the traumatologist, since if the bones coalesce improperly, this can significantly reduce the functions and disrupt the work of the entire hand.

Data of damage due to mechanical impact: shock, compression, compression.

The change in the position of bone fragments and the fracture itself can easily be detected with the help of palpation, which for the patient will prove unbearably painful.

The hand is unable to accept the position of the fist, the grasping function is greatly weakened. May form under the skin bruising, swelling, the finger itself may even seem smaller.

In cases where several bones are broken, the debris moves at an angle to the back of the palm. This position is preserved by the action of the muscles of the hand.

Diagnosis in a medical institution

In order to determine the localization, nature and severity of injury, doctors conduct the following types of examinations:

• visual inspection of , patient interview, collection of a full history, finding out the causes of injury;
• must be assigned radiography in two planes;
• for multiple fracture uses computed tomography .

Most often, the clinical picture in the case of such fractures is simple.

The physician easily identifies a trauma based on the symptoms and results of the diagnosis.

First Aid Assistance

In case of an open fracture, it is necessary to try to stop the bleeding and call an ambulance for further hospitalization.

With a closed fracture, the damaged limb should be fixed with a bandage, scarf or handkerchief to limit the displacement of broken bones and immediately send the injured person to the emergency room.

The fingers of the brush should be in a semi-bent state.

Objectives and methods of therapy

The goal of treating fracture of metacarpal bone is complete elimination of trauma, restoration of bone integrity, physiological position and functioning. Any type of treatment, regardless of the fracture, is carried out under the strict supervision of a doctor.

Treatment of any fracture begins with anesthesia with Procaine solution. If the case is uncomplicated, there are few debris and cracks, then conservative treatment is performed.

The surgeon presses on the back of the hand, shifting the fingers and broken bones to physiologically correct positions, eliminating the pathological wrong angle. Then the injured hand will be firmly fixed in one position with the help of gypsum.

Four weeks later, repeated radiography is performed in order to see how the fracture grows together. If this is a fracture of the first bone, then a plaster bandage is applied without litter with a back longe.

If the damage is complicated by displacement, the patient is sent for hospitalization. At the hospital, the doctor determines which type of surgery should be performed, whether debris removal is required.

If the fracture does not have a stable position, then after repositioning through the nail phalanx, the surgeon inserts a special pin for the skeletal traction of debris. The operation is performed under careful examination of fluoroscopy.

In the most difficult traumas, the hand under anesthesia is cut, the osteosynthesis is performed( directing and comparing the injured parts operatively directly, giving the fingers and hands a physiological position), insert the needle, the end of which is left above the surface of the skin.

Then the incision is sewn in a layered manner, a dense gypsum dressing is applied.

Depending on the nature of the fracture, the course of the operation, the intensity of deformation can be controlled by X-ray images 1-4 times per month. If the adhesion is successful, then after 3 weeks carefully remove the needle, the plaster is allowed to be removed after 2-3 weeks.

When the fracture is open before the beginning of repositioning and surgical intervention, the wound is cleaned from foreign objects, dirt, small fragments of bone, if any.

In the process of finding a hand in a cast, the patient will need to try to move his fingers as often as possible, so that the physiological function is not severely affected. With severe pain after surgery and discomfort in the process of splicing, doctors can prescribe analgesics.

Complications can occur both in the absence of a referral to a specialist, or in the case of improper performance of the doctor's instructions during treatment.

If the fracture is open, then infection and a purulent abscess are possible. Possible consequences of a closed fracture are in the wrong fusion of bones and pathological deformation.

How to avoid injury?

The best prevention of the appearance of metacarpal injuries is the observance of precautionary measures, safety rules, careful monitoring of the situation during the dragging of weights, while playing sports and other types of physical activity.

Those who are engaged in professional sports or heavy physical work at work will need to perform daily exercises for kneading the muscles of the hand, take vitamin-mineral complexes containing calcium, to strengthen bone tissue.