Name of the Procedure:

Closed Treatment of Metacarpal Fracture, Single; with Manipulation, Each Bone

Common names: Metacarpal Fracture Reduction, Manipulative Closed Reduction

Summary

This procedure involves realigning a broken hand bone (metacarpal) without making any incisions. The doctor carefully manipulates the bone into its correct position.

Purpose

The procedure addresses metacarpal fractures, which are breaks in one of the five long bones in the hand. The goal is to ensure proper bone alignment, promote healing, and restore hand function.

Indications

• Pain and swelling in the hand following trauma
• Deformity or abnormal positioning of a finger
• Difficulty moving the hand or fingers
• X-ray confirmation of a metacarpal fracture

Preparation

• Follow your doctor's instructions regarding fasting if sedation will be used.
• Inform your doctor about any medications you are taking; you may need to adjust or stop certain medications.
• Diagnostic imaging, such as X-rays, will be performed to assess the fracture.

Procedure Description

1. The patient’s hand is cleaned and sterilized.
2. Local anesthesia is usually administered to numb the area. In some cases, general anesthesia or sedation might be used.
3. The doctor manipulates the broken bone into its correct position by applying controlled pressure.
4. An X-ray is taken to confirm proper alignment.
5. The hand is immobilized using a splint or cast to keep the bone in place during healing.

Duration

The procedure typically takes about 30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or emergency room.

Personnel

• Orthopedic surgeon or hand specialist
• Nurse
• Radiologic technologist
• Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

• Infection
• Nerve damage
• Poor bone healing or malunion
• Stiffness or reduced range of motion
• Need for future surgery if the bone doesn’t heal correctly

Benefits

• Proper alignment of the fractured bone
• Faster and more effective healing
• Restoration of hand function
• Reduction in pain and swelling

Recovery

• Keep the hand elevated to reduce swelling.
• Follow the doctor's instructions for wound care and splint or cast management.
• Take prescribed pain medications as directed.
• Avoid activities that could stress the hand.
• Follow-up appointments will be needed to monitor healing.
• Physical therapy may be recommended to restore function.

Alternatives

• Open reduction and internal fixation (surgery) if manipulation is not successful or the fracture is severe.
• Non-surgical management with splints if manipulation is not needed.
• Pros of alternatives include more precise bone stabilization via surgery; cons include higher risk and longer recovery.

Patient Experience

During the procedure, the patient will feel pressure as the bone is manipulated but should not feel pain due to anesthesia. Post-procedure, there might be some discomfort, soreness, and swelling. Pain management will be provided, and patients should rest and avoid strenuous hand activities.