A metacarpal fracture brace is a small, hand-based brace that wraps around the palm and the back of the hand and holds a broken metacarpal in line, while the FINGERS AND WRIST KEEP MOVING.
It’s used for stable metacarpal shaft fractures and many boxer’s fractures that aren’t rotated.
Because the fingers move from the start, the stiffness that often follows a hand cast is less of a problem.
How it holds the bone
- Three-point pressure: firm pads over the back of the hand and in the palm, either side of the fracture, keep the bone from bowing
- The soft tissue does part of the work. Compressed muscle and skin around the bone act like a natural splint
- The knuckles stay free, so the tendons glide over the healing bone and don’t stick to it
- Using the fingers helps, because muscle contraction inside a snug brace adds to the support
A bone can heal in a brace while the fingers work. It’s the fingers that stiffen in a cast.
Who it suits
- Stable metacarpal shaft fractures without shortening or rotation
- Many boxer’s fractures of the little finger metacarpal neck, within the angle your clinician accepts
- People who need to keep working or looking after family, where a bulky splint would stop them
Who it doesn’t suit
- Rotated fractures. If the finger crosses its neighbor when you make a fist, a brace won’t fix it
- Several metacarpals broken at once, or fractures into the knuckle joint
- Open wounds or severe swelling in the first days. A gutter splint often comes first
A typical timeline
- Days 0 to 7: gutter splint or bandage while swelling settles, then the brace is fitted
- Weeks 1 to 4: brace worn full time. Full finger movement and light use from the start
- Weeks 4 to 6: brace for activity once the bone is no longer tender and the X-ray looks right
- Weeks 6 to 8: grip strengthening, and heavier work and sport building up
Wearing it well
- Tighten the straps daily as swelling drops. A loose brace does nothing
- Check your fist every day for the first two weeks. Fingers should point towards the base of the thumb, not cross
- Keep the hand raised in the first week to control swelling
- Keep the skin dry under the pads
Get it checked if
- A finger starts to cross its neighbor
- A new bump or step appears on the back of the hand
- Pain increasing after the first week
- Numbness, color change or skin breakdown under the pads
This is one of dozens of splints a hand therapist makes. See what a hand therapist does for the full list.
Hold the bone, free the fingers, and check the fist every day.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.