ANSWERS: 3
  • It totally depends on how each individual person heals. I suggest you go to a doctor on this one, if you already have then just listen to his directions. Broken bones are a lot bigger of a deal then most people think. You can have loose bone fragments that can seriously hurt you more, or it can be misaligned and heal wrong or heal weak. All of witch can leave you with crippling illness and injury, and that's not even touching the possibility of internal bleeding and infections. ---- Heal time also depends on type of break: Nondisplaced fractures can be managed with splinting for 3 weeks followed by protected active range of motion. Noncomminuted fractures with greater than 25% of the articular surface involved and/or greater than 1 mm of articular displacement should be treated with ORIF. Use a dorsal approach, splitting the extensor tendon to view the joint. Perform anatomic reduction under direct vision. Care must be taken during the operation to avoid stripping of soft tissues to minimize the risk of avascular necrosis of the metacarpal head. Fixation of head fractures can be accomplished with K-wires, cerclage wiring, or interfragmentary screws. Fixation should be stable enough to allow early motion. --- Comminuted fractures present a major problem. K-wire and cerclage wire fixation often fail. Multiple fine wires or even resorbable braided suture placed through drill holes made with fine K-wire as a drill bit may provide better reduction and, ultimately, greater reintegration of important small bone fragments. Condylar plate fixation is bulky and anatomic fixation is very difficult, with the exception of the second and fifth metacarpals. Acceptable results can be obtained by immobilization of the MCP joint in 70° of flexion for 2 weeks, followed by aggressive therapy. Skeletal traction on transverse pinning or external fixation may be necessary to distract a comminuted joint, especially if the base of the proximal phalanx is concomitantly fractured. Distraction radiographs can be helpful in determining if this is the most appropriate method of treatment. --- Open fractures require operative debridement and irrigation. Cleansing is typically followed by stabilization, using either internal or external fixation. Metacarpal neck fractures with small lacerations over the MCP joint should be assumed to be the result of a human bite (fight-bite) and should be treated by joint lavage and appropriate antibiotics. The author recommends ampicillin/sulbactam (Unasyn), followed by its oral equivalent, amoxicillin/clavulanate potassium (Augmentin), each of which has a good broad spectrum but also specifically covers Eikenella corrodens, a common and destructive oral contaminant. Operative stabilization of fractures can be accomplished by several methods. Most fractures can be stabilized with simple Kirschner wire (K-wire) fixation. The K-wire can be placed longitudinally or transversely into the adjacent metacarpal. Longitudinal pin fixation is usually stable but requires that the pin pass through the extensor sheath and can lead to stiffness if the pins are not removed in 3-4 weeks. Transverse pin placement can provide stability without splinting and allow for earlier motion. --- Most cases of closed metacarpal shaft fractures are managed nonoperatively The Jahss splinting technique, whereby the finger is kept in flexion with upward force applied across the PIP joint, should not be used as the risks of skin necrosis, joint stiffness and flexion contracture are contraindicative. Immobilization should be continued for 4-6 weeks. Immobilization should not continue longer than 6 weeks, as stiffness and tendon adhesions can limit range of motion and lead to poorer results. Many fractures reduced and splinted have recurrent angulation due to the force of the intrinsic muscles on the fracture. For this reason, it is sound to consider undertaking such reductions in a setting where percutaneous pinning may be performed to provide more rigid stabilization. --- Metacarpal base fractures Fractures of the fifth metacarpal base frequently require internal stabilization. When this pattern is nondisplaced or minimally displaced (<1-2 mm), it can be managed nonoperatively by splinting for 4 weeks. More often, the fracture displaces because of the deforming forces of the extensor carpi ulnaris (ECU) and the flexor carpi ulnaris (FCU) via its linkage to the pisometacarpal ligament. These forces tend to displace the fragment dorsally and proximally. Although such a fracture may be easily reduced, it is usually unstable because of these forces. The author prefers closed reduction with percutaneous pin fixation. --- CMC injuries Usually these fractures are easy to reduce but difficult to maintain due to deforming forces. Recommended treatment is closed reduction and pin fixation to stabilize the CMC joint. Pin placement can either transit the CMC joint or secure the reduced metacarpal to the adjacent metacarpal shaft. Patients are splinted postoperatively for 3 weeks, after which they are encouraged to begin movement. The pins should be removed after 6 weeks. --- ------------------------------------------ Most metacarpal injuries are managed by closed reduction and immobilization or sometimes controlled mobilization utilizing a dorsal block splint. Indications for operative treatment include the following: Failure to achieve or maintain acceptable reduction using closed techniques Open fractures Multiple hand fractures Complex injuries Displaced intra-articular fractures Fractures with severe soft tissue loss requiring a stable skeleton
  • Most patients i look after have had their hands immobilized for a minimum of 4 weeks, again depends on how severe the break is. i broke my meta tarsals and was plastered for 4 weeks :)
  • Well, I am going through this right now. This is my second time to fracture my 4th metacarpal. My doctor put me in a cast with all of my last three fingers imobilized. He did not put anything in between my fingers, therefore I had very painful sores that came up on my nuckles because he casted my fingers together to tight. Therefore there was no blood flowing to these areas. I was in my cast for 2 weeks. My doctor took my cast off 5 days ago and I am in so much pain..... I went back to see him today and he suggests that it might be carpul tunel syndrom.....so he gives me a shot of Cordazone and slaps a brace on me and sends me on my way.....still in a lot of pain! I'm going on 4 weeks of being in unbearable pain. I feel like he is thinking that I am faking it or something. First of all I have to drive 2 hours just to see him and I have no insurance. Like I would really waste my time and money just to fake a broken hand. Yea Right!!! So the answer to this question is there is no telling.....I guess it just depends on who your doctor is and if he is in a hurry or not!!!! Good luck!!!

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