مقاله تخصصی
Fracture of the metacarpal bone
3 months ago
949 بازدید
Dr. Mohammad Hossein Delshad
تهرانpain companions
Metacarpal bone fracture is a fracture of the tubular bones in the palm. This condition is usually seen in athletes, especially in boxers, for this reason it is also called "boxer's fracture".
Each of your fingers has a metacarpal bone, and each of these metacarpals may be broken by a high-energy impact on the athlete's hand.. It should be noted that this injury can also be seen in sports other than boxing.
Hand metacarpal fractures and damage to other tissues
When this fracture occurs, it's not just the bones in the hand that are damaged, some of the soft tissues in your hand are also affected. Soft tissues include:
- muscles
- ligament
- tendons
- nerves
What is the cause of metacarpal bone fracture?.. Metacarpal fractures are always caused by impact and usually occur as a result of hitting an object with a clenched knuckle.
Weak bones (such as bones with osteoporosis) are more prone to fracture....Generally, a metacarpal fracture occurs when the hand collides with another object with great force, eventually leading to a fracture of the metacarpal bone.
Usually this occurs when punching with a clenched fist....by doing so, the knuckles or the heads of the metacarpal bones hit the hard object directly and the full force of the impact causes a fracture.
This is why boxers are more prone to this type of fracture than other people, especially when they do the sport without gloves.
What symptoms does a metacarpal bone fracture cause? As we said, this complication is caused by a punch or a direct impact caused by falling.... In these cases, you feel a lot of pain in your hand, especially in the part that was hit... There is a significant amount of swelling and bruising in the affected area.... Also, its intensity is very high in some people.
When a physical examination is performed by a pain specialist, the patient's hand is more sensitive in the area of the affected metacarpal than in other parts of the hand.
For some people, at the end of the fracture, the broken bone is palpable and if you press on that point, movement is felt.
If the fracture is angular, the hand will bend slightly inward in line with the palm and you will feel a point at the tip of the fracture.
One of the other important signs that a doctor can detect a fracture of the metacarpal bone is whether there is rotational deformation in the fracture area or not.
In these cases, the patient is asked to make a fist, when the hand is in this position, the fingers should be properly extended and parallel.
If the metacarpal of the finger is broken and not aligned with the other fingers, the end of the broken part may be rotated.
It is possible to develop this complication in any sport and athlete, although it is more common in sports where there is a risk of high-energy impact to the athlete's hand. For example, it is seen in boxing and other martial arts.
How is a fracture of the metacarpal bone diagnosed?
When you go to the doctor for a complication, in the first step of diagnosis, questions about your medical history will be asked and then a physical examination will be done.
If necessary, the doctor will ask the patient to do an X-ray for a better examination and final diagnosis... Sometimes additional things like a CT scan are needed for a more detailed and accurate view of the fracture to determine the best treatment method.
How is a metacarpal bone fracture treated?
The treatment solutions are different depending on the conditions of each person.. but in general these treatment solutions are considered for the patient:
### Non-surgical treatment of metacarpal fracture
To immobilize a metacarpal fracture, a splint or cast should be used.... An ulnar splint, also called a boxer splint, should be used for fourth or fifth metacarpal fractures that leave the thumb, ring, and index fingers free.
For fractures of the second or third metacarpal, a splint with a small finger and a free ring should be used.
The splint does not completely surround the hand and forearm and has a soft cover so that it does not cause any problems for the patient in case of swelling.
Usually, the tips of the fingers are left free from the splint so that it has some movement and is not stiff... Usually, the splint is used for six weeks and then physical therapy is considered for the patient.
### Surgical treatment
Furthermore, after more detailed examinations and x-rays, the next decision should be whether you need surgery.
If the wound is open or if you need to repair ligaments or tendons, eventually surgery is necessary... Finally, after the surgery and after the bones have healed, splinting and a period of physical therapy should be done.
Time to see a doctor
Often, athletes suffer acute injuries during professional training, which can be controlled and treated with home methods in most cases.
If the symptoms of the injury are serious, the patient should remain calm and immobile until medical examinations and treatment procedures are performed by the doctor.
Serious and emergency symptoms of a metacarpal bone fracture that require a doctor's examination are as follows:
- Change of bone or joint that is deformed or broken.
- There is swelling or severe pain.
- The patient has unstable breathing and pulse.
- The patient feels confused.
- tingling or numbness is felt.
Also, if you cannot control your symptoms with home remedies, be sure to see a doctor for treatment.
When can you return to daily activities?
To start the daily activities, you have to try this action yourself.... At first, do only those activities that you feel you have the ability to do.
### Driving
Once you have removed the splint, you should be able to do activities such as driving, but only if you have full control of your vehicle.
### Back to work activity
Whether or not you can return to your work activity depends on the type of work.
If you don't feel pain, you can do your daily activities.... You can increase your activities over time.
Decreased strength and flexibility may make it a bit difficult for you to get started... If you take your activities slowly, it will be possible for you to work.
Program and recovery process after metacarpal fracture
Points to keep in mind during the recovery process after a fracture are as follows:
### 0 to 2 weeks after injury
Your finger may stick to the side finger.. but try to move the joints that are stuck together.... After the injury, pay attention to these things:
- Control your pain and swelling.
- Do light activities with your hands.
- Avoid lifting heavy equipment.
- Avoid deleting hot items.
### 2 to 6 weeks after injury
In the meantime, pay attention to the following:
- Increase your hand movements and exercises.
Try to move three joints of each finger every hour.. But don't do it by force.
- You should gradually increase your daily activities.
### 6 to 12 weeks after injury
At 6 and 12 weeks post-injury, keep these tips in mind:
- During this period, you no longer have any obstacles to carry out daily activities.
- You should resume your normal daily activity.
- If you do certain activities and sports such as boxing, at least three months should pass before you can do higher intensity activities.
