![]() ![]() These bones are supplied by the three metacarpal arteries that arise from the deep volar arch and join (anastomose) the three common digital branches of the superficial palmar arch at the head of the metacarpals. Metacarpal of the little finger: With the hamate.Metacarpal of the ring finger: With the hamate, as well as the capitate.Metacarpal of the middle finger: With the Capitate.Metacarpal of the index finger: With both the trapezoid and the trapezium.Metacarpal of the thumb: With the trapezium.The five metacarpals form prominent articulations on their base or proximal end, with one or more of the four distal carpal bones : The joints between the metacarpal and carpal bones are all plane synovial joints, except the thumb as it is a saddle joint (another form of synovial joint). ![]() Carpometacarpal Joints (Carpal-Metacarpal Joints) These joints form the most prominent knuckles of the hand. The first metacarpal articulates with the proximal phalanx of the thumb, the second metacarpal with the proximal phalanx of the index finger, and so on. ![]() Each metacarpal forms a smooth articular facet on its distal end or head to articulate with the corresponding proximal phalanx. Metacarpophalangeal Joints (Metacarpal-Phalangeal Joints)Īs the name suggests, these are the joints between proximal phalanges (finger bones) and metacarpal bones. This arrangement forms the hollow of the palm, making it flexible along with the fingers. The four medial (the four except the thumb) metacarpals are joined with each other through articular surfaces at the base, while their distal ends are joined by ligaments. The metacarpals form important joints and articulations on both ends: Articulations Between the Medial Metacarpals Metacarpal Base: The enlarged proximal end (the lower end on the side of the wrist) the third metacarpal has a styloid process projecting dorsally, extending behind the capitate. ![]() On its dorsal aspect, there is a triangular area on the distal side. Metacarpal Body/Shaft: The long part between the head and the base the metacarpal shaft has a concave palmar aspect, and sides. The area right below the head is referred to as the neck of a metacarpal. Metacarpal Head: The rounded distal end (the upper end on the side of the fingers). The study population is planned to be 21 patients in each group.Metacarpal Bones X-Ray Image Anatomy of the Metacarpals Parts of a MetacarpalĮach of these long bones can be divided into three parts: The overall satisfaction of the patients and the costs for both treatments will be documented as well. The investigators will measure return to driving, work and sport.Ĭomplications will be registered continuously for all patients. The finger ranges of motion and pain will be evaluated with every follow-up, DASH score, range of motion, pain and grip-strength will be measured after 12v and 1 year. Radiographs will be performed at 1v and 6v. The participant will be seen for a follow-up at 1, 6 and 12 weeks and 1 year. A physiotherapist controls that early mobilisation is carried out. Furthermore the participants in the conservative group are allowed to use their hands without any restrictions. By this procedure shortening oft he metacarpalfractures is limited by the function of the deep transverse metacarpal ligament connecting the distal parts of the metacarpalbones II-V. The conservative group is instructed to do a fist to correct any malrotation and to rehabilitate quickly. The operative group is treated with internal fixation and 2 weeks in a cast. The patients are divided into two groups (operative and conservative treatment with early mobilisation). The study is designed as an prospective, randomised controlled trial. Procedure: Early mobilisation Procedure: Operation The study is designed to answer the question if early mobilization is not inferior to operative treatment but with lower costs and without any operation related risks. An advantage of early mobilization is that the patient avoids the risk of an operation and the costs for the treatment are decreased markedly. In those cases the fractures may heal with some shortening but very good function. New studies have shown that even displaced fractures can be treated with early mobilization. Even if this is an standard procedure both mild and severe complications have been reported. This usually includes an open reduction of the fracture and fixation with plates and screws or just screws. With appreciable displacement especially any malrotation the patient usually is treated with an operation. With minimal displacement this fracture is usually treated with immobilisation or early mobilisation. Spiral metacarpal fractures (metacarpal II-V) can be treated conservatively or with operation.
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