![]() ![]() Likewise, Boxer’s fracture may also need advanced imaging studies such as CT. ![]() CT and possibly fluoroscopy may be needed to properly diagnose these fractures. Plain radiographs are useful for initial evaluation of a metacarpal fracture but may not be able to show the nuances of a Bennett’s or Rolando’s fracture. The mechanism of injury is an important part of the history that will establish suspicion for a metacarpal fracture. Fractures of the metacarpal shaft will present with localized pain and swelling. Rolando’s fracture presents simply with pain and swelling at the carpometacarpal joint. A Bennett’s fracture will show pain and bruising and instability at the junction of the metacarpal with the wrist. Bennett’s and Rolando’s fractures will present with symptoms overlying the base of the thumb at the wrist. The knuckle may also appear depressed and range of motion at the knuckle may be limited or occur with a popping sensation. In a Boxer’s fracture, the symptoms will be present at the affected knuckle joint. Tenderness, pain, and swelling over the affected area are the hallmarks of a metacarpal fracture. What are the symptoms of a Metacarpal Fracture? The fifth metacarpal shaft can be fractured by a direct blow as would be seen in a “karate chop”. It can also result from a fall onto the thumb. Bennett’s fracture occurs when the hand is clenched in a fist and the metacarpal is partially flexed, as occurs in a fall from a bike where the hand is wrapped around the bike handle. Rolando’s fracture is caused by force applied to the metacarpal base while the thumb is tucked within the fist, from either an awkward fall or from striking a fixed object in that position. Boxer’s fractures are most commonly caused by striking an object with the knuckles of a clenched fist. Metacarpal fractures are almost always a result of trauma. In Rolando’s fracture, the same metacarpal base is fractured, but a Y shaped split results in a comminuted fracture, where the bone has fractured into multiple small pieces. Bennett’s fracture occurs at the base of the first metacarpal where it articulates with the carpal bones of the wrists. A boxer’s fracture usually involves metacarpal V, but can occur in metacarpals 2-4 as well.īennett’s and Rolando’s fractures involve the first metacarpal bone. One type of metacarpal fracture, the Boxer’s fracture, occurs at the neck of the metacarpal bone closest to the end that forms the knuckle. There are, however, some locations more commonly fractured than others. The metacarpals can fracture at any location along their length or ends. As a result, the metacarpals are prone to fracture. These five bones are shaped like long, thin rods and are very delicate. Metacarpal I is the bone in the palm which connects to the thumb, and metacarpal V corresponds to the bone of the little finger, or “pinky”. There are five metacarpal bones, each articulating with a digit of the hand. These bones, located between the bones of the wrist and the bones of the fingers, are called the metacarpals. A metacarpal fracture is a type of hand fracture occurring in the bones which form the palm of the hand. ![]()
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