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What is a metacarpal fracture?

A fracture of a metacarpal is a break in one of the knuckle bones. Physiotherapy is an important part of the rehabilitation following a metacarpal fracture.

How can a metacarpal fracture occur?

A fracture of a metacarpal is commonly caused by punching a hard surface or by being hit on the hand by an object travelling at high speed.

Soft tissue massage and mobilisations of the metacarpal bone jointsAbove: Soft tissue massage and mobilisations of the metacarpal bone joints

What are the symptoms of a metacarpal fracture?

Immediate and intense pain is felt at the site of the fracture when a metacarpal bone is broken. This will be somewhere between the knuckle and the wrist. When you look at the hand it is usually very swollen and bruised. There may also be an obvious lump or deformity where the bone is broken. This results from movement or displacement of the bone pieces when the metacarpal is broken. Other symptoms include:

What should I do if I have fractured a metacarpal?

If you have or suspect that you have this injury, you should go directly to your nearest accident and emergency department. To help control your pain and limit the amount of swelling, you should apply ice to the hand. Ideally, this should be a bad of frozen peas or crushed ice wrapped in a moist towel or cloth applied for up to 20 minutes. You can also apply compression with an elastic bandage around the injured site. It should be a little tight but not tight enough to cause you increased pain. At the accident and emergency department they will take an X-ray of your hand to view the bones. From this, they can provide you with a diagnosis and determine the appropriate treatment. This could involve wearing a splint or, in some cases, surgery to put the bones back in their original position and to hold them there.

Physiotherapy treatment following a metacarpal fracture.

When the bone has healed, your physiotherapist will be able to assist in returning you to normal activity and, if required, return to participation in sports. This involves treatments to reduce pain and swelling, improve joint range of movement, and stretching and strengthening exercises. Other treatments include:

What shouldn’t I do if I have fractured a metacarpal?

If you have or suspect that you have fractured a metacarpal, you should not perform activities which could cause the broken ends of the bone to move on one another until it has been assessed in accident and emergency. You should also avoid any activities which may increase the blood flow to the injured area as this may increase bleeding and swelling around the broken ends of the bone and potentially prolong your recovery. These include hot showers, heat rubs, massage and the consumption of alcohol.

Could there be any long-term effects from a metacarpal fracture?

The majority of metacarpal fractures heal without complication in a matter of weeks. However, a proportion of injuries can result in longer-term effects because a number of nearby structures may also be injured when a metacarpal bone is broken. These include the surrounding joints and cartilage, nerves, blood vessels, ligaments and tendons. Injury to these structures may delay recovery.

To arrange a physiotherapy assessment call on 0330 088 7800 or book online.

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