Metacarpal fractures are usually caused by direct violence such as blows or crush injuries and can be single or multiple metacarpal fractures. Transverse and comminuted fractures are the most common types of fractures, and oblique or spiral fractures may occur as a result of twisting and indirect violence. Treatment requires both adequate fixation and appropriate early movement to facilitate recovery of hand function. Principles of metacarpal fracture treatment: both adequate fixation and appropriate early activity are required to facilitate the recovery of hand function. For uninjured fingers absolutely no immobilization should be done to ensure the movement of other fingers. The fracture must be properly repositioned without angulation, rotation, or overlapping displacement. The tip of each finger is pointed to the navicular tuberosity when flexed individually. If the finger tips point to the radial or ulnar side of the navicular tuberosity after flexion, the fracture has a rotational or lateral angular deformity and must be corrected, otherwise the fracture will result in crossed fingers when the fist is healed. For open fractures, the first step is to strive for one-stage wound healing, while paying attention to the correct revision of the fracture. For fractures and dislocations of the metacarpals, phalanges and wrist bones, most of them are treated with closed reduction external fixation. Indications for surgery: open fractures, dislocations and fracture dislocations are treated with one-stage debridement and internal fixation to close the wound. Displaced, hard-to-replace or unstable fractures with or without subluxation and dislocation of the joint surface; unstable diaphyseal fractures that cannot be easily repositioned; complete avulsion fractures of the lateral collateral ligaments of the joint, causing joint instability, especially large pieces of ligaments attached to the joint surface or fracture blocks impinging on the joint surface; complete avulsions of the stops of the lateral collateral ligaments, causing joint instability, especially in the metacarpophalangeal joint of the thumb, the metacarpophalangeal joint of the index finger The radial aspect of the metacarpophalangeal joint of the thumb, the metacarpophalangeal joint of the index finger, and the proximal interphalangeal joint of the little finger are involved; unstable dislocation or fracture dislocation that cannot be easily repositioned; internal fixation of the fracture in order to remove a foreign body or a free bone block in the joint, which may cause infection, sinus tracts, or unevenness of the joint surface; closed injury combined with hand spacing syndrome, which requires decompression in order to prevent soft tissue ischemia and necrosis causing contracture of the intrinsic muscles of the hand; separation of the epiphyseal plate that cannot be easily repositioned or is unstable The epiphyseal plate separation. The following are postoperative films of comminuted metacarpal fractures.