Conservative Treatments

When it comes to metacarpal and phalanx fractures of the hand, once the facture is reduced (set), it is immobilized (splint). Once the bone is determined to be clinically healed, active motion is encouraged around 3-4 weeks post injury. Around 6-8 weeks, once approved by the doctor, the patient is encouraged to decrease splint wear to night time wear. Strengthening typically begins around 7 to 8 weeks post injury.

Surgical Intervention

If the fracture is severe enough and can’t be reduced (set) conservatively, there are two very common methods utilized by orthopedic surgeons. These two methods are Open Reduction Internal Fixation (ORIF), or percutaneous pinning.

With percutaneous pinning of the metacarpal fractures, the pins are removed around 3-4 weeks post op (5-6 weeks for proximal or middle phalanx fracture / 3 weeks for a distal phalanx) if the surgeon determines that the fractures are clinically healed. Stay in communication with your surgeon’s office after the surgery! Make that follow up appointment because it’s important!

ORIF is when a plate is attached to the bone with screws. The benefits to the ORIF is that the healing process is expedited due to reinforcing hardware!

With percutaneous pins, it’s important to ensure that there is no infection, because the pins do protrude through the skin, or they are very close to the surface of the skin. It’s important to call your doctor if you experience excessive redness, numbness, drainage (pus), excessive numbness, or a fever above 100 degrees. Keeping the sites clean every day helps prevent infection or complications.