UMEM Educational Pearls

Metacarpal fractures are frequently seen in the ED.

These are frequently non operative injuries.

For  4th and 5th metacarpal fractures, consider an ulnar gutter spilt.

For 2nd and 3rd metacarpal fractures, consider a radial gutter splint.

Splinting position (Intrinsic plus):  

Wrist in approximately 20 degrees of extension (position of function)

MCP joint in 70 to 90 degrees of flexion

Slight flexion at the DIP and PIP and DIP joints.      

              -Important to prevent shortening of the collateral ligaments