title: Surgical treatment, hardware removal, and the wide-awake approach for metacarpal fractures.
abstract: Most fractures are managed nonoperatively. Those displaced unstable fractures require percutaneous fixation of single (or double) intramedullary Kirschner wires. Only large, oblique fractures must be fixed with screws or a plate. Indications for plating metacarpal fractures are limited in multiple unstable shaft or oblique fractures. After internal fixation, the patient actively moves the digits over a limited range under protection. This article reviews indications and techniques of surgical treatment, hardware removal, and the wide-awake approaches for surgery of these fractures.
authors.affiliation: Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong 226001, Jiangsu, China.
authors.forename: Shu Guo
authors.initials: SG
authors.lastname: Xing
authors.affiliation: Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, 20 West Temple Road, Nantong 226001, Jiangsu, China. Electronic address: jinbotang@yahoo.com.
authors.forename: Jin Bo
authors.initials: JB
authors.lastname: Tang
mesh_terms: D001864:Bone Wires; D020878:Device Removal / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D050279:Metacarpal Bones / Q000293:injuries*
keywords: Hardware removal; Internal fixation; Metacarpal fracture; Wide-awake surgery