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Fifth metacarpal fracture

Case contributed by Derek Smith
Diagnosis certain

Presentation

Threw punch 10 days prior to presentation. Attended ED with ongoing pain and swelling to knuckle. Distally neurovascularly intact. Right hand dominant. Previous right boxer fracture.

Patient Data

Age: 35 years
Gender: Female
x-ray

Transverse fracture to midshaft of right fifth metacarpal bone. There is minimal rotation but about 80 degrees of palmar angulation. Mild soft tissue swelling over fracture.

Post-manipulation

x-ray

Post-reduction film. Splinting and cast noted.

Better alignment to right fifth metacarpal. Reduction in palmar angulation to about 30 degrees.

Case Discussion

Although the patient was delayed in their presentation, the hand specialists were satisfied with the reduction achieved and advised them to remain in cast with no surgical intervention at this time.

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