Last Friday  we saw Jonas Valanciunas leave the game against the Lakers with a finger injury. It was later determined that he had broken his left 4th metacarpal bone. What is the Metacarpal bone? The palm of the hand primarily comprises of 5 long bones known as the metacarpals. The metacarpal bones form joints with the small bones of the wrist known as the carpal bones and the small bones of the fingers known as the phalanges.

Signs & Symptoms

Patients with this condition typically experience a sudden onset of intense hand pain at the time of injury. Pain may be felt on the front, back or sides of the hand and can occasionally settle quickly leaving patients with an achiness of the hand that is particularly prominent at night or first thing in the morning. Pain may also radiate into the fingers or wrist of the affected hand.

How to Diagnose

An X-ray is usually required to confirm diagnosis and assess the severity. Further investigations such as an MRI, CT scan or bone scan may be required, in some cases, to assist with diagnosis and assess the severity of injury.

Treatment
Most of the time, the bones can be realigned by manipulating them without surgery. A cast, splint or fracture-brace is applied to immobilize the bones and hold them in place. The cast will probably extend from the fingertips down past the wrist almost to the elbow. This ensures that the bones remain fixed in place.

A second set of X-rays will probably be needed about a week later. These X-rays are used to ensure that the bones have remained in the proper position.

The cast will be worn for three to six weeks. Gentle hand exercises can probably be started after three weeks. Afterward, the finger may be slightly shorter, but this should not affect the ability to use the hand and fingers. Once the cast comes of  chiropractic care and acupuncture can be used to improve mobility and restore strength.

It was recently reported that Jonas has decided to go with this option and not have surgery at this point an exact return to play date can’t be confirmed but I do suspect we are looking at least a 5-6 weeks.

In some  hand fractures require surgery to stabilize and align the bones. These fractures usually break through the skin or result from a crushing accident. An orthopaedic surgeon can implant wires, screws, or plates in the broken bone to hold the pieces of the fractured bone in place.

After the bone has healed, the surgeon may remove the implants or may leave them in place.
The physician may want to examine the hand periodically to ensure that the joint doesn’t tighten (contract) during healing.

Joint stiffness may be experienced because of the long immobilization period. Exercises can help restore strength and range of motion. This is where I come  into play. With various treatment protocols included exercises, joint mobilizations and soft tissue therapy patients are capable of making a full recovery.

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