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Updated: Sep 16, 2025

Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Metacarpal Fractures: An Evidence-Based Review to Guide Treatment
Natalie Stash1, Robin N Kamal, Marc Richard
1From the University of California-San Francisco, San Francisco, CA (Stash), the Orthopaedic Surgery, Stanford University, Stanford, CA (Kamal), the Orthopaedic Surgery, Duke University, Durham, NC (Richard), and the Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA (Shapiro).
Abstract:
Metacarpal fractures are among the most common fractures of the hand and upper extremity and can lead to substantial disability. Clinical and radiographic features of these fractures are important in approaching their management. While most metacarpal fractures can be treated nonsurgically with reduction and/or immobilization, some fractures and patients can have improved patient-centered outcomes with surgical fixation. Outcomes of surgical fixation (eg, percutaneous Kirschner wire fixation, plate/screws, interfragmentary screws alone, and intramedullary fixation) and postoperative care are best when tailored to the fracture pattern and patient.
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Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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