The major goal in the treatment of metacarpal fractures is to restore the normal function of the hand. Radiological criteria and the clinical extent of displacement should be individually considered when taking the decision for or against conservative treatment. Internal fixation techniques must protect soft tissue structures. Small screws and plates have proven effective for head and shaft fractures, whereas intramedullary splinting is favoured for neck fractures. In instable and displaced fractures of the base of the first metacarpal, surgery is regularly performed to restore the bony shape and articular surface. To prevent functional impairments, early mobilization is desirable both during conservative treatment and following internal fixation.
