What is Metacarpal Fracture

Metacarpal fracture is a break (fracture) of a bone in the hand. Metacarpals are the bones that go from your knuckles to your wrist.

You have five metacarpal bones in each hand. This fracture is usually caused by a fall or an injury that crushes the hand.

This injury is diagnosed with medical history, a physical exam, or imaging tests, such as an X-ray.

What are the signs or symptoms?

Symptoms of this condition may include:

• Pain.
• Swelling.
• Stiffness.
• Bruising.
• Inability to move a finger.
• A finger that looks misshapen.
• An abnormal bend or bump in the hand or finger (deformity).

How is this treated?

Treatment depends on how bad the injury is.

• If your broken bone is still in place and did not move, you may need:
  • To wear a splint or cast for several weeks.
  • To have the broken finger taped to another finger next to it (buddy taping).
• If the broken bone has pieces that moved and no longer line up, your doctor may:
  • Do surgery to fix the bones into place with metal screws, plates, or wires.
  • Move the bones back into position without surgery (closed reduction).
• After your bones are put together, you will need to wear a splint or cast for several weeks.

Treatment may also include:

• Physical therapy after your cast or splint is removed.
• Follow-up visits and X-rays to make sure you are healing.

Follow these instructions at home:

If you have a splint:

• Wear the splint as told by your doctor. Remove it only as told by your doctor.
• Loosen the splint if your fingers or toes tingle, become numb, or turn cold and blue.
• Keep the splint clean.
• If the splint is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

If you have a cast:

• Do not stick anything inside the cast to scratch your skin.
• Check the skin around the cast every day. Tell your doctor about any concerns.
• You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
• Keep the cast clean.
• If the cast is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Activity

• Do not lift or hold anything with your injured hand.
• Return to your normal activities as told by your doctor. Ask your doctor what activities are safe for you.
• Do exercises as told by your doctor.

Driving

• Do not drive or use heavy machinery while taking pain medicine.
• Do not drive while wearing a cast or splint on a hand that you use for driving.

Managing pain, stiffness, and swelling

• If told, put ice on the injured area. Put ice only if you have a splint, not a cast.
  • If you can remove your splint, remove it as told by your doctor.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your fingers often. This helps to prevent stiffness and swelling.
• Raise the injured area above the level of your heart while you are sitting or lying down.

General instructions

• Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your doctor.
• Do not take baths, swim, or use a hot tub until your doctor says it is okay. Ask your doctor if you may take showers. You may only be allowed to take sponge baths.
• Take over-the-counter and prescription medicines only as told by your doctor.
• Keep all follow-up visits as told by your doctor. This is important.

Contact a doctor if:

• Your pain is worse.
• You have redness, swelling, or pain that gets worse.
• You have a fever.
• There is a bad smell coming from your cast or splint.

Get help right away if:

• You have very bad pain under the cast or in your hand.
• You have trouble breathing.
• The following happen, even after you loosen your splint:
  • Your hand or fingernails turn blue or gray.
  • Your hand feels cold or numb.

Summary

• A metacarpal fracture is a break (fracture) of a bone in the hand.
• Treatment depends on how bad the injury is. You may need a cast or splint for a broken bone that did not move. You may need surgery for a very bad injury that moved the pieces of bone in your hand.
• Follow your doctor’s instructions for taking care of your injury after treatment.