Management of Metacarpal and Phalangeal Fracture Malunions.

Morrell, Nathan; Kelley, Naomi H; Pidgeon, Tyler S · J Am Acad Orthop Surg · 2026

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Abstract

Fractures of the metacarpals and phalanges are common. Inadequate management of these injuries frequently results in malunion. Although the hand is capable of adaptation to some malalignment, malunions of the metacarpals and phalanges are often functionally notable. In these cases, surgical correction may result in improved outcomes. Corrective osteotomies are capable of improving coronal, sagittal, and axial plane malalignment. Preoperative software-assisted osteotomy planning and 3D-printed cut guides are contemporary innovations that make treatment of these difficult problems much more approachable.