ORIF 4th MC Fracture lag screw

Metacarpal fractures can be treated non-operatively but if they are displaced or unstable it is preferable to repair them operatively with an open reduction internal fixation (ORIF). This allows the bone to be rigidly fixated so range of motion exercises can be started almost immediately post-operatively allowing near complete recovery once the bone has healed. Spiral oblique fractures can result when a rotatory force is applied to the digit. Some spiral oblique fractures can be repaired with a lag screw technique when the length of the fracture exceeds twice the width of the bone.


Lateral view of spiral oblique fracture with a bone spike of the distal fragment protruding dorsally at the base of the 4th metacarpal.







AP view of longitudinal spiral oblique fracture base of left 4th metacarpal,







Intra-operative view showing anatomic reduction and two lag screws in place rigidly fixating the fracture.







Post-operatively demonstrating full flexion.








Full extension.