Presentation
Punch injury of left hand
Patient Data
Age: 35 years
Gender: Female
From the case:
Metacarpal fractures
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Comminuted fractures are seen at the base of the 2nd, 3rd, and 4th metacarpals with mild displacement especially at the 2nd and 3rd metacarpal levels. Osteoarthritic changes are seen at the 1st metacarpophalangeal joint, seen as narrowed joint space, subchondral sclerosis and marginal osteophytes.
Case Discussion
This case is an uncommon consequence of an intentional closed fist injury. In this case, there is 5th metacarpal sparing, which is commonly involved. A study of Intentional Closed Fist Injuries has suggested that 61% of punch injuries were to the fifth metacarpal, 21% were to the remainder of the metacarpals and the remaining were fractures to phalanges and bones of the wrist 1.
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