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Metacarpal fractures

Other common names

Boxer's fractures

Who does it affect?

Metacarpal fractures often occur in males.

Why does it happen?

A punching type injury is the most common cause of a metacarpal fracture.  This may either occur with the hand striking another object or the hand falling from a height and, in effect, punching the floor or solid object.

Symptoms

People notice immediate pain on the back of the hand, and there may be clinical deformity.

Diagnosis

You will be asked to bend and straighten the fingers to ensure they are aligned and do not twist on flexing.  In addition to this your consultant will assess that the tendons both on the front and the back of the finger have not been injured during the accident.

The vast majority of metacarpal fractures can be treated non-operatively with early mobilisation.  The little finger metacarpal is the most common, and this can accept a significant degree of angulation, without functional problems. However, the index and middle finger metacarpals can tolerate less angular deformity, and often require fixation.

X-rays are used to evaluate metacarpal fractures.

Non-surgical treatment

The vast majority of metacarpal fractures occur in the little finger and require no operative treatment.  Early mobilisation is the key to a successful outcome.

Surgical treatment

This is usually reserved for severely angulated fractures, and also fractures involving multiple metacarpals.  Fractures involved in the index and middle finger have an increased likelihood of requiring internal fixation due to the inability to tolerate angular deformity on this side of the hand.  Operative treatment can include plates, screws and buried wires.  Individually tailored solutions will be discusses with you prior to treatment.

Post-surgery rehabilitation

Early mobilisation of the hand aids healing and prevents tendons from sticking to the underlying bone.

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