Closed treatment.
Percutaneous needle penetration
After closed reduction, stable epiphyseal fractures or simple intra-articular fractures can be treated with percutaneous needle penetration and then, immobilisation in a splint or cast. As in the kapanji technique.
External fixation brace
After satisfactory reduction, good maintenance of reduction can be obtained with an external fixation brace; sometimes a kapanji pin is required for additional fixation of the fragmented fracture and to prevent loss of reduction; external fixation can be used as an adjunct to treatment or temporary fixation, and external fixation combined with a different internal fixation can also be useful.
Open reduction internal fixation.
Metacarpal plate
Most commonly used. Palmar displaced fractures, extra-articular fractures, and most dorsal displaced fractures can be resolved with the palmar Henry approach.
Dorsal approach
Includes shear fractures of the radial styloid process, some complex four-part intra-articular fractures, some dorsally displaced fractures.
Specific Plates
e.g. triple column plates, radial column plates, ulnar column plates etc.