Most common
Splinting or Casting
Stable, nondisplaced and acceptably aligned fractures can often be treated with a splint, cast or brace. Follow-up X-rays may be used to confirm that alignment is maintained.
Urgent orthopedic hand-fracture care
Metacarpal Fracture Treatment & Hand Surgery in Atlanta
Prompt evaluation for broken hand bones, displaced metacarpal fractures and boxer’s fractures, including splinting, metacarpal nail fixation and plate-and-screw repair.
Do not wait for a hand fracture to “settle down.”
Many metacarpal fractures are stable and do not need surgery, but some can shift, shorten or rotate as swelling changes. Early evaluation helps protect alignment and hand function.
Urgent fracture appointments
Most treated without surgery
Nail or plate fixation
Early-motion planning
Understanding the injury
What Is a Metacarpal Fracture?
The metacarpals are the five long bones in the palm that connect the wrist to the fingers and thumb.
How Metacarpal Fractures Occur
These fractures can occur after a fall, direct impact, sports injury, crush injury or punching injury. A fracture of the fifth metacarpal near the little finger is often called a boxer’s fracture.
Pain, swelling, bruising and difficulty gripping are common. A knuckle may appear flattened, and a finger may cross over another finger when making a fist if the fracture is rotated.
What We Evaluate
- Fracture displacement and shortening
- Finger rotation and alignment
- Whether the fracture enters a joint
- Whether the fracture is stable
- Skin injury or an open wound
- Whether more than one metacarpal is broken
A Fracture Can Look Acceptable and Still Shift
Most metacarpal fractures are nondisplaced or acceptably aligned and can heal without fixation. Even so, the hand must be examined and the X-rays reviewed because some fractures become more displaced, shortened or rotated as swelling decreases.
Treatment options
Most Metacarpal Fractures Do Not Need Surgery
The best treatment depends on stability, rotation, shortening, joint involvement, fracture pattern and the patient’s functional needs.
Selected transverse fractures
Metacarpal Nail Fixation
A small intramedullary metacarpal nail can stabilize selected transverse or short-oblique shaft fractures from inside the bone while limiting direct exposure of the fracture site.
When stronger fixation is needed
Plate and Screw Fixation
Plate fixation may be used for unstable, comminuted, long-oblique, multiple-metacarpal or selected joint-involving fractures when dependable alignment is needed.
Why Stable Fixation Can Permit Earlier Controlled Motion
When a displaced fracture requires surgery, stable fixation may allow the fingers to begin controlled motion earlier than prolonged immobilization. This can help limit stiffness and restore hand function while the fracture heals.
Early fixation is not necessary for every fracture. It is most useful when displacement, rotation, instability or functional demands make nonsurgical treatment less predictable.
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Reduce Swelling and Get Evaluated Early
Elevate the hand above heart level, move the uninjured fingers as allowed and follow splint instructions. Severe swelling can make examination, skin closure and surgery more difficult. Waiting too long can also allow the fracture to stiffen or begin healing in the wrong position, making reduction more difficult.
When surgery is considered
Which Metacarpal Fractures May Need Fixation?
Surgery is more likely when alignment cannot be maintained or when the fracture threatens hand mechanics.
Reasons Fixation May Be Recommended
- Finger rotation or overlap when making a fist
- Unacceptable displacement or shortening
- Fracture instability on repeat X-rays
- Multiple metacarpal fractures
- Open fractures or significant skin injury
- Joint-surface displacement
- Failure of splint or cast treatment
The Goal Is Functional Alignment
Not every X-ray needs to look perfect. The important issues are finger rotation, knuckle position, tendon balance, joint alignment and the ability to make a functional fist.
When fixation is needed, choosing a nail, screws, pins or a plate depends on the exact location and shape of the fracture.
Recovery and hand motion
Protect the Fracture Without Allowing the Hand to Become Stiff
Finger motion is an important part of recovery, but it must be balanced with fracture stability.
Immediately
Control Swelling
Elevate the hand and follow splint instructions while monitoring skin color, sensation and swelling.
As stability allows
Begin Finger Motion
Controlled motion begins according to the fracture pattern, treatment selected and surgeon’s instructions.
Later recovery
Restore Grip Strength
Heavy gripping, lifting and impact activities return after healing and hand motion are dependable.
Local orthopedic hand-fracture care
Metacarpal Fracture Treatment Serving Atlanta and the East Metro Region
Atlanta Bone and Joint Specialists provides urgent orthopedic evaluation, nonsurgical care and fixation for metacarpal and hand fractures.
Atlanta
Decatur
Snellville
Loganville
Fulton County
DeKalb County
Gwinnett County
Walton County
Tell our scheduling team that you have a confirmed or suspected hand fracture. Bring your imaging disc, radiology report and emergency-room or urgent-care paperwork. We make every reasonable effort to evaluate acute fractures quickly.
Metacarpal fracture FAQ
Frequently Asked Questions
Does every metacarpal fracture require surgery?
No. Most stable, nondisplaced and acceptably aligned metacarpal fractures can be treated with a splint, cast or brace.
Why should a nondisplaced fracture still be evaluated?
A fracture may be unstable and can shift, shorten or rotate as swelling changes. Examination and follow-up X-rays help confirm that the fingers remain properly aligned.
When is a metacarpal nail used?
A small intramedullary nail may be used for selected transverse or short-oblique shaft fractures when stable internal fixation and earlier controlled motion are desired.
When is a plate used?
Plate-and-screw fixation may be used for unstable, comminuted, long-oblique, multiple-metacarpal or selected joint-involving fractures.
Why does finger rotation matter?
A rotated metacarpal can cause one finger to cross over another when making a fist. Even a small rotational deformity can interfere with grip and hand function.
What should I do about swelling?
Elevate the hand above heart level, use the splint as directed and move uninjured fingers when allowed. Seek urgent evaluation for severe tightness, worsening numbness, color change or uncontrolled pain.
Do Not Let a Broken Hand Heal in the Wrong Position
Call Atlanta Bone and Joint Specialists for prompt evaluation of metacarpal alignment, rotation and stability—and a clear plan for splinting, nail fixation or plate fixation when needed.
This page provides general educational information and does not replace an examination, imaging review or individualized medical advice. Seek emergency care for an open wound, visible bone, severe deformity, rapidly worsening numbness, pale or cold fingers, uncontrolled pain or major trauma.