Non-thumb metacarpal fracture

Types

• Non-thumb metacarpal fracture (head)
• Non-thumb metacarpal fracture (neck)
• Non-thumb metacarpal fracture (shaft)
• Non-thumb metacarpal fracture (base)
• Boxer's fracture

Differential Diagnosis

Hand and Finger Fracture Types

• Non-thumb metacarpal fractures
  • Head
  • Neck
  • Shaft
  • Base
  • Boxer's fracture
• Thumb fracture
• Finger (Phalanx) Fracture
  • Proximal
  • Middle
  • Distal

Evaluation

Boxer's Fracture (4th metacarpal)

Boxer's Fracture (5th metacarpal)

Treatment

General Fracture Management

• Acute pain management
• Open fractures require immediate IV antibiotics and urgent surgical washout
• Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
• Consider risk for compartment syndrome

Metacarpal Fracture (Post-Reduction) Goals

Finger	Shaft Angulation (degrees)	Shaft Shortening (mm)	Neck Angulation (degrees)	Rotational Deformity
Index & Long Finger	10-20	2-5	10-15	None
Ring Finger	30	2-5	30-40	None
Little Finger	40	2-5	50-60	None

See Also

• Hand and finger fractures