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Spiral Metacarpal Fractures


- Discussion:
    - tend to rotate which is poorly tolerated;
    - 5 deg of MCP rotation leads to > 1.5 cm of digital overlap;

- Operative Treatment:
    - screw fixation for metacarpal frx
          - screw menu
          - when ORIF is indicated, interfragmentary lag screw fixation is used;
          - in large adults, 2.7 mm screws are used;
          - in smaller pts, 2.0 mm screws are used;
          - if screws are used w/o a plate, requires that the frx length will be at least twice diameter of the metacarpal;
          - a minimum of at least 2 screws are used;
                 - 2 screws will provide sufficient resistance to shear & torsional stress