Have just injured any metacarpal bone in your hand. And you are wondering what treatment options are available and how long it will take to heal and return to activities such as sports.
As a diagnostic radiographer who sees these kinds of fractures every other day, I will answer frequently asked questions about metacarpal fracture.
I also rely on studies that follow people who have broken a metacarpal bone for several weeks or months.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: April, 2025. Written by Juliet Semakula, a diagnostic radiographer.
▶️What is a metacarpal fracture? How common are they?
Metacarpal fractures are hand injuries that affect the metacarpal bones in the hand.
The image below demonstrates the different parts of metacarpal bones and different areas which are affected by metacarpal fractures.
Metacarpal fractures are common types of fractures which can be functionally disabling if not managed well.
You can break a single metacarpal or several at once, in this article I will discuss the treatment options and healing time of all types of metacarpal fractures.
🟣The fifth metacarpal (little finger)
🟣The second metacarpal (index finger)
🟣The third metacarpal (middle finger)
🟣The thumb metacarpal (1st or big finger): here is a dedicated article for thumb metacarpal fracture
Most of the time these fractures are non-displaced, but they can also be displaced.
Your doctor will take time when examining your injury, considering the particulars of the bone and soft tissues injury. Along with your medical, social, and psychological factors.
You will normally find precise information on the type of fracture you have got in your x-ray report.
▶️What causes a metacarpal fracture of the hand?
Metacarpal fractures can be caused by any injury to your hand, the most common injuries I have seen are caused by:
🟤Direct blows or punching a solid object.
🟤Sports injuries such as boxing, fractures of the metacarpals account for 39.2% of all sports-related fractures (Geoghegan,2021)
🟤Falls on an outstretched hand.
🟤Crushing injuries and motor accidents.
▶️What are the symptoms of a metacarpal fracture?
🔴You will feel pain at the fracture site.
🔴Dorsal hand swelling around the injury.
🔴You may feel loss of motion in your hand.
🔴Bruising and tenderness
🔴Deformity on the hand making it difficulty to move.
🔴Numbness and tingling
If you suspect a metacarpal fracture, it’s important to seek medical attention promptly.
▶️How is a metacarpal fracture treated?
The primary goal of metacarpal fracture treatment is to provide enough stability to allow early motion which will reduce the potential for stiffness and chronic dysfunction.
Stiffness is the most common complication in the management of hand fractures.so early range of motion exercises is encouraged
Most metacarpal fractures I have seen with minimal to mild deformity are treated non-operatively and achieve satisfactory clinical outcomes.
Surgical techniques and fixation options are normally used to allow early motion.
Non-operative management
🔴Immobilization with buddy taping or splinting are commonly used and early motion is started.
Your doctor will use buddy taping, splint or a removable brace to stabilise the fracture.
You will be encouraged to mobilise to prevent stiffness of the fingers.
Image of a functional brace used for temporary immobilization of non-displaced fractures of the metacarpals (Image from lambi,2023)
Surgical management
When your doctor decides that your fracture requires surgical stabilisation. You will be given the details in your medical details and what kind of surgery your fracture requires.
There are different types of fixations, and these depend on how severe your metacarpal fracture is displaced and your medical health condition.
Here are some of the types of surgery fixation I have observed being done in theatre.
♦️ Plate fixation
I have seen most displaced metacarpal fractures being fixed with plate fixation which is seen as the most stable form of fixation for metacarpal fractures
However, this type of fixation can lead to increased postoperative stiffness, tendon irritation and adhesions sometimes (Bennett,1889)
♦️Percutaneous pinning
This is a common method of operative fixation. The K-wire fixation is a minimally invasive option that helps to stabilise the fracture patterns and minimizes trauma to uninjured soft tissue
However, k-wire fixation has a greater risk of loss of fixation compared to more stable fixation that can be obtained with screws, plates and nails (Lambi,2023).
♦️ External fixators
These are not commonly used in the hand but can play a role in stabilisation metacarpal fractures that have segmented bone defects and soft tissue injuries.
♦️Lag or interfragmentary screws
This type of fixation is known to provide greater stability than k-wires and does not require soft tissue stripping that is fundamental to plate and screw placement.
However, this type of fracture fixation is ideal for long oblique patterns, if the fracture length is greater than 2.5 times the width of the bone. Lag screws can be considered (lambi,2023)
▶️Disadvantages of some of these methods of fixation include:
🟠Pin tract infections and osteomyelitis.
🟠Over-distraction or discomfort.
🟠 Neurovascular injury.
🟠Loosening the fracture through pinhole sites once removed.
Metacarpal of fractures of the second and and middle metacarpal shaft of the hand.
X-ray of DP and LAteral metacarpal fractures of the second and third metacarpal shaft of the hand,
X-ray images (E)showing post operation of the first stage after third metacarpal shaft IM nail fixation and second metacarpal shaft Masquelet procedure with K-wire placement.
Image (F) showing the second metacarpal shaft iliac crest bone grafting and smooth IM nail fixation (Lambi,2023)
▶️How long should the splint or immobilisation be kept?
Whether or not you have had surgery for your metacarpal fracture, you are usually prescribed orthopaedic treatment for a few days or weeks of relative immobilisation.
How long you must wear the splint will vary greatly depending on the type of metacarpal injury you have got and what your doctor recommends.
Some people wonder if a metacarpal fracture can heal without a cast or splint.
The answer to this is yes, assuming conditions are right, and it is a minor hairline fracture. However, and very importantly it does not work in all cases. You will need a splint for proper healing.
Sometimes if left to heal without a splint or cast it may heal improperly. By this I mean the bones may not heal in correct alignment leading to a malunion or a non union fracture
Your doctor or physiotherapy will determine how long you should keep the brace or splint; this is usually based on an individual case.
However, these factors normally influence how long immobilization is required.
⚫Severity of the injury.
⚫Type of splint you have got on.
⚫ Individual healing
⚫ Underlying condition
⚫What kind of treatment you have got.
The aim of this immobilisation is to encourage consolidation and relieve pain.
Usually wearing a splint is limited in time, as there’s a risk that your finger will become stiff and interfere with your daily activities.
A splint, tape or cast is normally kept on until your follow up X-ray or even a little less around 2 to 4 weeks.
The x-ray always shows how well your fracture is consolidating and helps the doctor to determine whether you still need it on or not.
In any case you feel the given time of immobilisation is too long or short, you can always discuss it with your physiotherapist or doctor to see what is best for you.
▶️And why is it important to protect the break whilst healing?
When your doctor gives you a brace or splint to help with your fracture immobilisation and healing.
You should wear them as instructed because it will help:
⚫Immobilise and stabilise the fracture site and protect your hand joints.
⚫Reduce pain.
⚫Decrease swelling around the affected area.
⚫It will help promote proper bone alignment.
⚫Promote proper bone healing.
⚫It will help minimise stiffness and promote normal hand function.
If you are having some of these symptoms or suspect a metacarpal fracture, it’s important to seek medical attention promptly to allow the best treatment as early as possible.
▶️How long does it take for a metacarpal fracture to heal?
Most metacarpal fractures I have seen typically take
🟡3 to 4 weeks to consolidate without surgery.
🟡3 to 6 weeks after an operation or more
🟡6 to 8 weeks to heal completely but this will depend on how severe your injury is and the kind of treatment you get.
🟡 Return to normal it can take several months before your hand feels completely normal
Some people find soreness and stiffness persisting longer even after you have been given a green light by your doctor.
If you had several broken metacarpals at once or other associated fractures, it may take a few weeks longer to heal.
However your finger fractures will consolidate, it is very rare for metacarpal fractures not to consolidate.
Finger bones normally consolidate quickly as they are short bones with little stress.
To allow quick healing, try to avoid activities that could re-injury the hand, especially sports activities or lifting heavy things.
For the first few days after your fracture, you are allowed to use your arm on the fractured side to eat if the splint does not prevent you from doing so.
As soon as the splint is off you can gradually restart your hand as before.
If you feel a lack of flexibility or strength you can always consult a physiotherapist to see what you can do to regain mobility in your fingers.
The average healing time for a metacarpal fracture is 49 days. That’s why a follow up x-ray is often taken after 1 month of injury.
It is normal to have aches, discomfort and for the area to be more sensitive for several months after the injury.
Here are some of the estimated healing times of a metacarpal fracture from follow-up patients and medical studies.
| Phases | Estimated timeline |
| Less pain | A few days |
| Swelling subsidizing | Few days to weeks |
| Bone consideration. | The bone fracture starts healing within 3 to 4 weeks. |
| Light activities using the hand | 4 to 6 weeks after the fracture |
| Length of wearing a splint | 2 to 4 weeks will depend on a follow up x-ray and how well you are healing. |
| Full strength in your hand | 6 to 8 weeks. |
| Return to normal activities like sports | When your finger is completely healed, it will always depend on what kind of sports.4 to 6 weeks or more depending on how you are healing. |
| How long to go back to workSome people continue to walk with metacarpal fractures, it will depend on your professional and how well your hand is healing. | For a non-operated fracture time off work 3 days for sedentary work ,And up to 42 days for very physical work.Incase of surgery 7 to 42 days |
Estimated healing time-line of metacarpal fractures
We have come to the end of this article,any questions or comments let’s meet in the comments section!
You may also be interested in these articles.
⚫Living with a non-union fracture.
⚫Metacarpal fracture of the thumb recovery time
⚫Can you drive with a splint?
⚫How long does a broken bone take to heal?
⚫Dislocated finger.
Below are some of the resources used in this article,you can explore them more.
📚Sources:
Lambi AG, Rowland RJ, Brady NW, Rodriguez DE, Mercer DM. Metacarpal fractures. J Hand Surg Eur Vol. 2023 Sep;48(2_suppl):42S-50S. doi: 10.1177/17531934231184119. PMID: 37704027.
Bennett EH. On Fracture of the Metacarpal Bone of the Thumb. Br Med J. 1886 Jul 3;2(1331):12-3. doi: 10.1136/bmj.2.1331.12. PMID: 20751614; PMCID: PMC2257374.
Geoghegan L, Scarborough A, Rodrigues JN, Hayton MJ, Horwitz MD. Return to Sport After Metacarpal and Phalangeal Fractures: A Systematic Review and Evidence Appraisal. Orthop J Sports Med. 2021 Feb 23;9(2):2325967120980013. doi: 10.1177/2325967120980013. PMID: 33709003; PMCID: PMC7907947.
Keller MM, Barnes R, Brandt C, Hepworth LM. Hand rehabilitation programmes for second to fifth metacarpal fractures: A systematic literature review. S Afr J Physiother. 2021 May 31;77(1):1536. doi: 10.4102/sajp.v77i1.1536. PMID: 34192208; PMCID: PMC8182452.