Presentation
Trauma to the hand. Pain, swelling and slight deformity.
Patient Data
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Oblique fracture of the base of the 5th metacarpal bone with 2 mm radial displacement of the fractured fragment and proximal displacement of the metacarpal bone by 3 mm. The 5th carpometacarpal joint is also involved and results in a 3 mm step. Soft tissue swelling adjacent to the fracture site is also noted.
Case Discussion
The intra-articular fracture dislocation of the base of the 5th metacarpal bone is called reverse Bennett fracture and is analogous to Bennett fracture of the thumb. Vigorous and unopposed pull from the extensor carpi ulnaris muscle causes proximal migration and subluxation of the fracture fragment; these fractures are quite unstable.