Metacarpal Base Fx


  Initial Treatment
Splint type & position Dorsal and volar splints
Wrist, 30-degree extension; MCP, free
Initial follow-up visit Within 5 to 7 days
Pt instructions Icing, elevation
  Follow-up Care
Cast or Splint type & position Short-arm cast; wrist, 30-degree extension
Length of immobilization 4 weeks
Healing time 6 to 8 weeks
Follow-up visit interval Weekly for 3 weeks; then every 2 weeks
Repeat radiography interval At 5 to 7 days to check position
Weekly for a total of 3 weeks
Pt instruction Begin ROM exercises after immobilization (flexion and extension of wrist and handgrip strengthening)
Orthotic protection for 4 to 6 weeks after cast is removed
Indications for orthopedic consult All fifth metacarpal base fractures
Malrotation
Ulnar nerve injury
Subluxation or dislocation of CMC joint
Inability to maintain reduction