Metacarpal Screw Fixation: Your Journey from Preparation to Full Recovery
Stop NSAIDs, aspirin, herbal supplements and vitamin supplements 7 days before surgery; discuss blood thinners with surgeon, stop smoking 6 weeks before.
Do not eat or drink after midnight; do not shave or wax the operative area; shower and wash the hand with usual soap; remove nail polish and trim nails; avoid lotions, perfumes, jewellery.
Shower, wash operative hand with usual soap, wear loose clothing; take only approved medications with a sip of water; bring imaging/ID and arrive early.
Maintain the operative splint or cast clean, dry and intact; keep hand elevated to reduce swelling; ice the hand for 20–30 minutes every 2 hours; you are non‑weight bearing in your splint immediately after surgery; begin gentle shoulder pendulums and active elbow and wrist motion 24 hours after surgery; formal physical therapy typically begins 2 weeks after surgery【561081450151602†L11-L20】【561081450151602†L48-L56】.
Non‑weight bearing in splint or cast for first 0–2 weeks; at 3–4 weeks continue cast and still no weight bearing but move elbow and shoulder; at 4–5 weeks wear removable wrist splint except for hygiene, avoid lifting more than 5 lb; from 6 weeks onward remove brace and progress weight bearing as tolerated; after 8 weeks may return to weight‑bearing, sports, and use of vibrating tools.
Keep dressing in place; keep hand elevated above heart; make a fist five times an hour while awake; may use hand for light activities such as eating, writing, typing and dressing (1–2 lb); if pins were placed, there should be NO motion of involved fingers【601991897626319†L4-L19】.
First follow‑up at 10–14 days to remove post‑operative dressing and evaluate incisions; pins (if used) remain and patient is placed back in splint; second follow‑up at 5–8 weeks to remove pins and discontinue splint; third follow‑up at 12 weeks to assess healing and permit unrestricted activities
Gentle range‑of‑motion exercises start when splint is discontinued around weeks 4–5; avoid axial loading (bench press, push‑ups) until after week 8; weight bearing as tolerated begins at 6+ weeks with strengthening of shoulder, elbow, wrist and hand; patient may return to light functional activities after 8 weeks.
Most patients achieve full range of motion and unrestricted activities by approximately 12 weeks; progressive strengthening and return to sports or heavy work around 8–10 weeks when fracture has healed and pain has resolved.