Opening and closing a fist regularly (around 10 times every half an hour) will help prevent stiffness. If the injury is unstable, a period of 10-14 days immobilisation may be recommended, but it is still important to keep the hand moving. It is safe to mobilise the hand immediately following a stable metacarpal injury. Vitamins C and D are important in bone healing, so a healthy diet helps too. Many factors influence the outcome of fracture healing, but the vast majority of fractures heal without complication and most fractures will heal within 4-6 weeks. Smoking have been proven to delay healing, and it is worth considering giving up(!). Plates on the metacarpals with fractures now healed. Generally speaking, the preferred method of treatment in Fife is to use a bone plate. There are a number of different techniques used by surgeons including putting wires into the bone. Surgery – Surgery may be recommended again where the injury is unstable. Splints are recommended where the fracture is not too displaced. Splint / plaster – The aim of using a splint or plaster is to provide stability to the hand for the first few weeks while the majority of healing occurs. In an UNSTABLE injury, or where 2 or more metacarpals are broken, there are a number of options: The bone heals quickly, within around 3-4 weeks in the majority of stable fractures. It is important to keep the injured finger moving, and although buddy taping keeps the hand more comfortable, it is not necessary to tape the fingers. Pain can be an issue initially, and for this reason the broken finger is often ‘buddy taped’ to the finger next door to help support it. STABLE injuries will heal quickly and without treatment. In addition, the muscles of the hand cover most of the bones, and these structures help to maintain the stability of the hand when a metacarpal is broken. The metacarpals are tightly bound to each other at both ends with strong ligaments. This means that despite the break in the bone, the bone moves as one unit. The vast majority of metacarpal fractures are stable. There is swelling and tenderness over the metacarpal, and the normal contour of the metacarpal head is lost when the fingers are curled into a fist. In crush injuries and high energy injuries such as a fall from a bike, the injury pattern is less predictable, and the breaks are more often unstable (see below). Metacarpals can also break, however, if they are twisted, and this is often how rugby and football players generally get this injury. The most common mechanism of breaking a metacarpal bone is punching something hard with the fist clenched.
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