Thumb Metacarpal Fracture S62.246A 815.03

• 815.03(closed)
• 815.13(open)

Thumb Metacarpal Shaft Fracture Etiology / Epidemiology / Natural History

• Rotational deformity associated with oblique and comminuted fractures

Thumb Metacarpal Shaft Fracture Anatomy

• See Hand Anatomy.

Thumb Metacarpal Shaft Fracture Clinical Evaluation

• Generally have obvious pain and deformity at the fracture site.
• Document neurovascular status before and after any reduction. 

Thumb Metacarpal Shaft Fracture Xray

• P/A and lateral views of thumb 

Thumb Metacarpal Shaft Fracture Classification / Treatment

• Non-displaced
  -Thumb spica cast for 6 weeks (CPT=26600 closed treatment MC fracture without manipulation, each bone: 26605=with manipulation)
• Displaced (angulation >30 degrees, shortening >4mm,  rotational deformity)
  -CRPP vs ORIF 
• See also: Bennett's Fracture 815.01:  Rolando Fracture 815.01 S62.233A S62.236A

Thumb Metacarpal Shaft Fracture Associated Injury

• Bennett's Fracture 815.01  
• Rolando Fracture 815.01 S62.233A S62.236A

Thumb Metacarpal Shaft Fracture ORIF Complications

• Malunion
• Nonunion
• stiffness
• hardware failure
• complex regional pain syndrome
• infection
• (Fusetti C, J Trauma 2002;52:535)

Thumb Metacarpal Shaft Fracture Follow-up

Thumb Metacarpal Shaft Fracture Review References

• Rockwood and Greens
• Greens Hand Surgery