Metacarpal fracture

Changed by Mark Thurston, 6 Mar 2018

Updates to Article Attributes

Body was changed:

Show markup changes

Metacarpal fractures are common. Fracture of the metacarpal bones accounts for 10% of all fractures and 40% of all hand fractures. The lifetime incidence of a metacarpal fracture is 2.5%.

Terminology

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

Bennett fracture dislocation
Rolando fracture
epibasal thumb fracture
gamekeeper's thumb (not always includes a fracture)

Specific names are given to fractures of the fifth metacarpal:

fracture dislocation of the base of the 5th metacarpal: reverse Bennett fracture dislocation
fracture of 5th metacarpal neck: Boxer fracture

Epidemiology

Fractures of the 5th metacarpal make up 25% of all metacarpal fractures (which equates to 10% of all hand fractures.

Pathology

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:

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

~~-<a href="/articles/gamekeeper-thumb">gamekeeper's thumb</a> (not always includes a fracture)</li>~~
+<a href="/articles/gamekeeper-thumb">gamekeeper thumb</a> (not always includes a fracture)</li>

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":25447,"studyId":7787,"caseSlug":"fifth-metacarpal-fracture-2","caption":"Case 1: 5th metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/25447/71679f0c41b3c77c5592530ab2eb8a70ab75127dde6c5009e6776b764d498bbc_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":2943913,"studyId":21739,"caseSlug":"fifth-metacarpal-fracture","caption":"Case 2: 5th metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/2943913/be5c4ddb7ee845625a29381f942e6d_big_gallery.JPEG","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":25524,"studyId":7812,"caseSlug":"metacarpal-fracture-little-finger-2","caption":"Case 3: 5th metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/25524/de59cdbaaa48911b537bb3da94cebd90e56b8272e8ad6cb622dbd10bbcb52e8b_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":130085,"studyId":8223,"caseSlug":"4th-metacarpal-fracture","caption":"Case 4: 4th metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/130085/downloaded_image20211020-1627-1fod5mr_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":23990483,"studyId":51145,"caseSlug":"spiral-fractures-of-the-4th-and-5th-metacarpals","caption":"Case 5: undisplaced spiral of 4th and 5th shafts","thumbnail":"https://prod-images-static.radiopaedia.org/images/23990483/eebf69f82d066f768f9c6cc8b75aea_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":34486321,"studyId":64020,"caseSlug":"fifth-metacarpal-fracture-5","caption":"Case 6: 5th metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/34486321/d7ee5701b4e232a1258f39a06ab569_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":52774245,"studyId":90350,"caseSlug":"forth-metacarpal-fracture","caption":"Case 7: 4th metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/52774245/9207aa339f9834faec61228b2f2ec4_big_gallery.jpeg","isStack":false,"diagnosticCertainty":null},{"imageId":53033879,"studyId":92752,"caseSlug":"acute-4th-metacarpal-and-old-5th-metacarpal-fractures","caption":"Case 8: acute 4th and old 5th metacarpal fractures","thumbnail":"https://prod-images-static.radiopaedia.org/images/53033879/93179bb4e4b5d001699ab783e2090f_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":54343844,"studyId":102705,"caseSlug":"metacarpal-fracture-3","caption":"Case 9","thumbnail":"https://prod-images-static.radiopaedia.org/images/54343844/110004_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":56684723,"studyId":115245,"caseSlug":"multiple-metacarpal-fractures","caption":"Case 10: 2nd to 5th metacarpal fractures","thumbnail":"https://prod-images-static.radiopaedia.org/images/56684723/0._big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":58786571,"studyId":122384,"caseSlug":"metacarpal-neck-fracture","caption":"Case 11","thumbnail":"https://prod-images-static.radiopaedia.org/images/58786571/0._big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":60242018,"studyId":129109,"caseSlug":"forth-metacarpal-fracture-1","caption":"Case 12: 4th metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/60242018/ce5702c24014dfe946c98facfdf5233bcbebf49bba3b0694893862f88eca2cda_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":63208283,"studyId":140297,"caseSlug":"third-metacarpal-fracture","caption":"Case 13: Third metacarpal fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/63208283/0133138a20a0aca47103fee06ee848a43f4f40b88220a35d8df4ddc3627c14db_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":63227768,"studyId":140400,"caseSlug":"first-metacarpal-midshaft-fracture","caption":"Case 14: first metacarpal midshaft fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/63227768/57a51dd749eb3e0fcba2e198281517a7edd8370e98592a067eb3fb0e9e90ce35_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":64031340,"studyId":143857,"caseSlug":"metacarpal-fracture-16","caption":"Case 15","thumbnail":"https://prod-images-static.radiopaedia.org/images/64031340/08f48443390b3299819c9b21128e7017d5a8353875860d64e4598b1f08e8e8ef_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":64208102,"studyId":144651,"caseSlug":"reverse-bennett-fracture","caption":"Case 16: reverse Bennett fracture","thumbnail":"https://prod-images-static.radiopaedia.org/images/64208102/a9b727280032d875264e0c1741e55416064dd75b3939cea3f36e47b3c6b2af7e_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"}],"ddx_inclusions":[{"imageId":57035725,"studyId":116802,"caseSlug":"pseudoepiphysis-of-the-2nd-metacarpal-base","caption":"Pseudoepiphysis of the 2nd metacarpal base","thumbnail":"https://prod-images-static.radiopaedia.org/images/57035725/0._big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"}],"lang":"us"}

Updating… Please wait.

Unable to process the form. Check for errors and try again.

Thank you for updating your details.

Metacarpal fracture

Updates to Article Attributes

Terminology

Epidemiology

Pathology

Articles

By Section:

By System:

Cases

Radiopaedia.org