Metacarpal fracture

Last revised by Ashesh Ishwarlal Ranchod on 23 Dec 2023

Metacarpal fractures are common accounting for 10% of all fractures and 40% of all hand fractures

Specific names are given to fractures of the base of the first metacarpal (see: fractures of the thumb):

Specific names are given to fractures of the fifth metacarpal:

The lifetime incidence of a metacarpal fracture is 2.5% ref. Fractures of the 5th metacarpal make up 25% of all metacarpal fractures (which equates to 10% of all hand fractures) ref

They are a result of direct or indirect trauma with the nature and direction of the force being directly related to the type of injury. Specific injury patterns include ref:

  • carpometacarpal (CMC) joint injury

    • metacarpal base fractures and dislocation of the CMC joint

  • metacarpal shaft and neck fractures

    • these are usually a result of axial loading or direct trauma (clenched fist and solid surface); torsional force may also result in this type of injury

  • metacarpal head injury

    • these are intra-articular fractures that result from axial loading or direct trauma; collateral ligament avulsion fractures are caused by forced deviation of the flexed metacarpophalangeal joint (MCPJ).

  • metacarpophalangeal joint dislocations

    • dorsal MCPJ dislocations are the most frequent and a result of forced hyperextension of the digit

  • in children, consider pseudoepiphysis at the base 2

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