Metacarpal fractures in the athlete

  • Maximillian Soong
  • Samantha Chase
  • N. George Kasparyan
Hand and Wrist Sports Medicine (E Tolo and L Dwyer, section editors)
  • 182 Downloads
Part of the following topical collections:
  1. Topical Collection on Hand and Wrist Sports Medicine

Abstract

Purpose of review

To describe current evaluation and treatment of metacarpal fractures in athletes

Recent findings

Biomechanical and clinical studies involving lower-profile, locking, shorter length, and double-row or separate-dual plate configurations, as well as intramedullary screw fixation, have demonstrated the potential benefits of internal fixation with promising results.

Summary

Treatment should be customized to the specific athlete and injury, and is often successful without surgery, or with percutaneous pin fixation. Internal fixation of metacarpal fractures has improved with new hardware and new techniques, and may expedite return to play, although further clinical studies are needed.

Keywords

Athlete Metacarpal fracture 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am. 2001;26(5):908–15. doi: 10.1053/jhsu.2001.26322.CrossRefPubMedGoogle Scholar
  2. 2.
    Nakashian MN, Pointer L, Owens BD, Wolf JM. Incidence of metacarpal fractures in the US population. Hand (N Y). 2012;7(4):426–30. doi: 10.1007/s11552-012-9442-0.CrossRefPubMedCentralGoogle Scholar
  3. 3.
    Tan V, Kinchelow T, Beredjiklian PK. Variation in digital rotation and alignment in normal subjects. J Hand Surg Am. 2008;33(6):873–8. doi: 10.1016/j.jhsa.2008.02.006.CrossRefPubMedGoogle Scholar
  4. 4.
    Cotterell IH, Richard MJ. Metacarpal and phalangeal fractures in athletes. Clin Sports Med. 2015;34(1):69–98. doi: 10.1016/j.csm.2014.09.009.CrossRefPubMedGoogle Scholar
  5. 5.
    McDonald LS, Shupe PG, Hammel N, Kroonen LT. The intermetacarpal angle screening test for ulnar-sided carpometacarpal fracture–dislocations. J Hand Surg Am. 2012;37(9):1839–44. doi: 10.1016/j.jhsa.2012.05.042.CrossRefPubMedGoogle Scholar
  6. 6.
    Tan JS, Foo AT, Chew WC, Teoh LC. Articularly placed interfragmentary screw fixation of difficult condylar fractures of the hand. J Hand Surg Am. 2011;36(4):604–9. doi: 10.1016/j.jhsa.2010.12.004.CrossRefPubMedGoogle Scholar
  7. 7.
    Fufa DT, Goldfarb CA. Fractures of the thumb and finger metacarpals in athletes. Hand Clin. 2012;28(3):379–88. doi: 10.1016/j.hcl.2012.05.028.CrossRefPubMedGoogle Scholar
  8. 8.
    Goldfarb CA. Commentary: metacarpal fracture in the professional baseball player. Hand Clin. 2012;28:389. doi: 10.1016/j.hcl.2012.05.029.CrossRefPubMedGoogle Scholar
  9. 9.
    Strauch RJ, Rosenwasser MP, Lunt JG. Metacarpal shaft fractures: the effect of shortening on the extensor tendon mechanism. J Hand Surg Am. 1998;23(3):519–23. doi: 10.1016/S0363-5023(05)80471-X.CrossRefPubMedGoogle Scholar
  10. 10.
    Tavassoli J, Ruland RT, Hogan CJ, Cannon DL. Three cast techniques for the treatment of extra-articular metacarpal fractures. Comparison of short-term outcomes and final fracture alignments. J Bone Joint Surg Am. 2005;87(10):2196–201. doi: 10.2106/JBJS.D.03038.PubMedGoogle Scholar
  11. 11.
    Hofmeister EP, Kim J, Shin AY. Comparison of 2 methods of immobilization of fifth metacarpal neck fractures: a prospective randomized study. J Hand Surg Am. 2008;33(8):1362–8. doi: 10.1016/j.jhsa.2008.04.010.CrossRefPubMedGoogle Scholar
  12. 12.
    Dunn JC, Kusnezov N, Orr JD, Pallis M, Mitchell JS. The boxer's fracture: splint immobilization is not necessary. Orthopedics. 2016;39(3):188–92. doi: 10.3928/01477447-20160315-05.CrossRefPubMedGoogle Scholar
  13. 13.
    Page SM, Stern PJ. Complications and range of motion following plate fixation of metacarpal and phalangeal fractures. J Hand Surg Am. 1998;23(5):827–32. doi: 10.1016/S0363-5023(98)80157-3.CrossRefPubMedGoogle Scholar
  14. 14.
    Bannasch H, Heermann AK, Iblher N, Momeni A, Schulte-Mönting J, Stark GB. Ten years stable internal fixation of metacarpal and phalangeal hand fractures-risk factor and outcome analysis show no increase of complications in the treatment of open compared with closed fractures. J Trauma. 2010;68(3):624–8. doi: 10.1097/TA.0b013e3181bb8ea0.CrossRefPubMedGoogle Scholar
  15. 15.
    Agarwal AK, Pickford MA. Experience with a new ultralow-profile osteosynthesis system for fractures of the metacarpals and phalanges. Ann Plast Surg. 2006;57(2):206–12. doi: 10.1097/01.sap.0000215925.58902.bc.CrossRefPubMedGoogle Scholar
  16. 16.
    Barr C, Behn AW, Yao J. Plating of metacarpal fractures with locked or nonlocked screws, a biomechanical study: how many cortices are really necessary? Hand (N Y). 2013;8(4):454–9. doi: 10.1007/s11552-013-9544-3.CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Sohn RC, Jahng KH, Curtiss SB, Szabo RM. Comparison of metacarpal plating methods. J Hand Surg Am. 2008;33(3):316–21. doi: 10.1016/j.jhsa.2007.11.001.CrossRefPubMedGoogle Scholar
  18. 18.
    Gajendran VK, Szabo RM, Myo GK, Curtiss SB. Biomechanical comparison of double-row locking plates versus single- and double-row non-locking plates in a comminuted metacarpal fracture model. J Hand Surg Am. 2009;34(10):1851–8. doi: 10.1016/j.jhsa.2009.07.005.CrossRefPubMedGoogle Scholar
  19. 19.
    Watt AJ, Ching RP, Huang JI. Biomechanical evaluation of metacarpal fracture fixation: application of a 90° internal fixation model. Hand (N Y). 2015 Mar;10(1):94–9. doi: 10.1007/s11552-014-9673-3.CrossRefGoogle Scholar
  20. 20.
    • Doarn MC, Nydick JA, Williams BD, Garcia MJ. Retrograde headless intramedullary screw fixation for displaced fifth metacarpal neck and shaft fractures: short term results. Hand (N Y). 2015;10(2):314–8. doi: 10.1007/s11552-014-9620-3. Retrospective study demonstrating intramedullary screw fixation CrossRefGoogle Scholar
  21. 21.
    • del Piñal F, Moraleda E, Rúas JS, de Piero GH, Cerezal L. Minimally invasive fixation of fractures of the phalanges and metacarpals with intramedullary cannulated headless compression screws. J Hand Surg Am. 2015;40(4):692–700. doi: 10.1016/j.jhsa.2014.11.023. Retrospective study demonstrating intramedullary screw fixation CrossRefPubMedGoogle Scholar
  22. 22.
    ten Berg PW, Mudgal CS, Leibman MI, Belsky MR, Ruchelsman DE. Quantitative 3-dimensional CT analyses of intramedullary headless screw fixation for metacarpal neck fractures. J Hand Surg Am. 2013;38(2):322–30. doi: 10.1016/j.jhsa.2012.09.029.CrossRefPubMedGoogle Scholar
  23. 23.
    Geurts G, van Riet R, Meermans G, Verstreken F. Incidence of scaphotrapezial arthritis following volar percutaneous fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach. J Hand Surg Am. 2011;36(11):1753–8. doi: 10.1016/j.jhsa.2011.08.031.CrossRefPubMedGoogle Scholar
  24. 24.
    • Etier BE, Scillia AJ, Tessier DD, Aune KT, Emblom BA, Dugas JR, Cain EL. Return to play following metacarpal fractures in football players. Hand (N Y). 2015;10(4):762–6. doi: 10.1007/s11552-015-9769-4. Retrospective study demonstrating rapid return to football after internal fixation CrossRefGoogle Scholar
  25. 25.
    • Kodama N, Takemura Y, Ueba H, Imai S, Matsusue Y. Operative treatment of metacarpal and phalangeal fractures in athletes: early return to play. J Orthop Sci. 2014;19(5):729–36. doi: 10.1007/s00776-014-0584-5. Retrospective study demonstrating rapid return to sports after internal fixation CrossRefPubMedGoogle Scholar
  26. 26.
    Soong M, Got C, Katarincic J. Ring and little finger metacarpal fractures: mechanisms, locations, and radiographic parameters. J Hand Surg Am. 2010;35(8):1256–9. doi: 10.1016/j.jhsa.2011.08.031.CrossRefPubMedGoogle Scholar
  27. 27.
    Clinkscales C. Sports-specific commentary on Bennett's fractures in professional basketball players: Bennett fractures and metacarpal fractures. Hand Clin. 2012;28(3):391–2. doi: 10.1016/j.hcl.2012.05.030.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Maximillian Soong
    • 1
  • Samantha Chase
    • 1
  • N. George Kasparyan
    • 1
  1. 1.Department of Orthopaedic SurgeryLahey Hospital and Medical CenterBurlingtonUSA

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