Scenario: Christopher was using a drill at work. The drill bit grabbed and twisted his whole hand. He sustained a 4th metacarpal spiral shaft fracture and when he bends his finger it crosses over the middle finger.
Treating a Metacarpal Spiral Fracture
The metacarpal bones are the long bones in the hand in between the wrist and the fingers. You have 5 metacarpals, the thumb being number 1, the little finger number 5. Christopher has fractured his 4th metacarpal, meaning the ring finger metacarpal.
A spiral fracture generally occurs in the shaft of the bone from a twisting or rotational force. Rotation at the fracture site can cause the finger to cross over another finger when bending into a fist.
Your hand therapist can assess your finger clinically and read your X-Ray to determine whether conservative treatment is possible or if a referral to a surgeon is necessary.
If surgery is not required, your hand physio or occupational therapist will fit you with a hand based splint in a position of safe immobilization. This allows the fracture to heal in the desired position without causing secondary stiffness at other joints.
All uninvolved joints will be moved immediately to prevent stiffness. Your splint will need to be adjusted for fit as swelling reduces and will need to be work for 4-6weeks. Weaning from the splint into a buddy strap may be required. Strengthening exercises will then be commenced.
If you have any questions about treating a hand fracture, or would like to book an appointment, please don’t hesitate to get in touch.