Presentation
Left hand crushed by 2 metal shelving units on wheels whilst at work, soft tissue swelling noted.
Patient Data
There are transverse fractures through the shafts of the second to fifth metacarpal bones with no intra-articular extension. Mild angulation and ulna-translation of the third and fourth metacarpal fractures are noted on the lateral wrist view. The second and fifth metacarpal fractures are not displaced. No joint dislocation is noted, with the carpal bones, distal radius and distal ulna remaining unremarkable.
Case Discussion
Metacarpal shaft fractures are often a result of axial loading or direct trauma to the hand, as was the case with this particular patient.
When there is the presence of more than one fractured and displaced metacarpal, each break further aggravates the instability, deformity and muscular imbalance within the hand 1-2. To avoid permanent stiffness and dysfunction, it is important to restore the hand's anatomy and stability. Failing to do so will result in the metacarpophalangeal joints creeping into extension and slowly stiffening, with loss of the longitudinal arch 1-2.
Unable to process the form. Check for errors and try again.