Fractures of the metacarpals exclusive of the thumb

1. 1. The seriousness of metacarpal fractures, commonly regarded as trivial injuries but frequently resulting in crippling deformities is emphasized. These disabilities far in excess of the apparent importance of the fracture are due, to a considerable extent, to the lack of interest and the less consideration generally given to the early treatment and immobilization of these fractures than that given to fractures of the larger bones. 2. 2. The difficulties of treatment with special reference to past progress made in the treatment of these fractures are briefly reviewed and discussed. 3. 3. A new method of treatment used in twenty-two cases of fractures of the four inner metacarpals including both shaft and the so-called knuckle fractures is presented. This method is believed to be superior to the older methods of treatment. The basis of treatment is the early correction of the primary anatomic deformity and the rigid fixation of the fragments, with the hand in the position of grasp (optimum function) but with all metacarpophalangeal and interphalangeal joints free during the period of immobilization. 4. 4. The results of treatment are shown in the accompanying tables and representative roentgenograms.