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Metacarpal Neck Fracture

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Metacarpal Neck Fracture

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Metacarpal Neck Fracture

Metal-car-pool Neck Fracture
DikeHAfifi
8 KEY FACTS
CHARACTERISTICS
Fifth Metacarpal Neck Fracture
(5) Hand Metal-car-pool Neck Fracture

Metacarpal neck fracture commonly occurs as a fifth metacarpal neck fracture and is commonly found in 30-40% of all hand fractures.

Boxer's Fracture
Boxer Fracture

A metacarpal neck fracture is also known as a boxer's fracture. It is commonly seen in street fighters and rarely in professional or high-level amateur boxing.

MECHANISM
Direct Trauma to a Clenched Fist Against Hard Surface
Trauma-spike Clenched Fist hitting Hard Surface

Besides punching, metacarpal neck fracture is caused by direct trauma to a clenched fist against a hard surface. This can be seen in a patient complaining of pain and swollen hand after punching a wall because of anger.

SIGNS AND SYMPTOMS
Pain
Pain-bolts

Patients may experience pain and focal bony tenderness on the fractured metacarpal. Findings of ecchymosis and tenderness of the palmar can help us suspect a fracture.

Swelling
Swollen

Patients can be seen with swelling of the fracture site. The patient may experience swelling around the first week or so. It can also occur with rotational deformity.

DIAGNOSIS
X-Ray
X-ray

An X-ray helps diagnose the presence of a fracture of the 5th metacarpal neck. It is important to check angulation during X-ray interpretation. The lateral view is used to help with this.

TREATMENT
Splints
Splint

An ulnar gutter splint is used to immobilize the fourth and fifth metacarpal neck fractures. Splinting is used not only as an initial immobilization but also as a definitive treatment, depending on angulation. The patient also needs supportive care, such as analgetic to treat pain.

Surgery
Surgeon

Surgery is indicated in patients with open fractures, complex fractures such as comminuted fractures, and significant angulation (>40 degrees in the fifth metacarpal fracture).

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