Metacarpal Shaft Fx

  Initial Treatment
Splint type & position Gutter splint: wrist, 30 degrees extension; MCP, 70 to 90 degrees; PIP or DIP, 5
to 10 degrees
Initial follow-up visit Within 5 to 7 days
Pt instructions Icing, elevation
  Follow-up Care
Cast or Splint type & position Gutter splint
Length of immobilization 4 weeks
Continue immobilization for another 2 weeks if no radiographic healing is
apparent at 4 weeks (allow gentle ROM out of splint daily during this time)
Healing time 6 to 8 weeks
Follow-up visit interval Every 2 weeks
Repeat radiography interval At 5 to 7 days to check position
Every 1 to 2 weeks to document position and healing
Pt instruction Begin ROM exercises after immobilization
Avoid contact sports for 4 to 6 weeks after immobilization or use orthotic
Indications for orthopedic consult Malrotation
Shortening >5 mm
Inability to reduce dorsal angulation or maintain reduction
Displaced fractures
Comminuted fractures
Fractures of more than one metacarpal