Hi everyone,
Hoping to get some insight from the experts here. I’m a 30-year-old software engineer in Sweden, and I’m pretty active—I play a lot of golf and padel, and I also play guitar and piano.
The Injury:
• Main issue: Spiral fracture of the 4th metacarpal diaphysis (Right hand). It has one cortical width displacement and some slight shortening.
• Secondary: A small, stable avulsion fragment at the base of the 5th proximal phalanx.
• The "Kicker": I have a light rotational malalignment. When I try to flex my fingers, the ring finger aims slightly more toward my pinky instead of the thumb/scaphoid.
The Current Plan:
I’m being treated in the Swedish public healthcare system. I’m currently in a cobra cast. At my 4.5-day follow-up, the doctor remade the cast and acknowledged the light rotation but advised against surgery. They believe I’ll regain the ability to make a full fist once it heals, even with the slight rotation.
My Concerns:
Since I need my hands for both my job and my hobbies (especially that "anchor" grip for golf and precision for the guitar), I’m worried that "good enough" for a general patient might not be enough for me.
Will a light ulnar (pinky-side) rotation lead to "scissoring" or overlap once the swelling is gone?
Does the spiral nature of the fracture make it likely to rotate more while in the cast?
The Surgical Window: If I wait a bit to see how it feels but it doesn't improve, is surgery (ORIF) still an option 2–3 weeks after the accident? Or does the window for a good result close much sooner?
Should I be pushing harder for a specialist Hand Surgeon (Handkirurg) review now? However, not sure if that is possible…
Any advice or experiences with similar fractures would be greatly appreciated!
PS: I'm using Gemini to help me write and format this since my right hand is currently out of commission. Thanks for understanding!