Metacarpal Fractures

Metacarpal Fractures
May 25, 2016

adult_hand_fx_metacarpal_collage“Metacarpal bones are the five bones that support the hand and join the wrist to the fingers. Any break in the head, neck or shaft of the metacarpals is termed as Metacarpal fractures and are known as Boxer’s, Bennett’s or Ronaldo’s fracture depending on their location”, says Dr. Gupta at present the head of shoulder and hand division at Max Healthcare.

“I believe or rather it has been my experience over a period of 25 years in the field that, the fifth metacarpal is the most prone to injury and fractures in the metacarpal neck are the most common and almost 40% of fractures in the human body are contributed by Metacarpal fractures with males from 10-29 being most susceptible to it”, asserts Dr. Gupta.

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“Any severe blow, fall from a bike or car accident can result in the fracture and the symptoms indicative of the fractures vary from immediate swelling, numbness and an intense pain to limited motion and instability in the fractured metacarpal is what I have generally observed are the common signs that most patients come to me with a popping sound that is an added symptom of a severe fracture”, coherently observes Dr. Gupta.

“Even after having successfully operated upon 6000 patients and keenly observed each debilitating condition closely, Fractures in the metacarpals are delicate and might affect the soft tissues or damage the neurovascular tendons. The complete impact of the fracture can be ascertained by radiographs, CT scan or Fluorography. The treatment techniques are formulated on the basis of location, nature or severity of the fracture and range from external fixation, therapy exercises, splinting to open or closed reduction with internal fixation.”

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Selfless strive to serve patients has taken him from AIIMS to The Medanta, and he stresses that, “The patient essentially has to understand that metacarpal fractures are common and can relatively be treated painlessly but to restore their mobility they have to keep on doing therapy exercises and do not immobilize the bone for a very long period of time.”


FAQ – Metacarpal Fractures

Fracture in the bones which form the part of hand are referred to as Metacarpal fractures. They can occur on the head, neck or shaft of the metacarpal and are known as Boxer’s, Bennett’s or Rolando’s fractures respectively.
Metacarpals are bones located between the bones of the wrist and fingers. Delicate, long and shaped like thin rods they are easily susceptible to fractures. These five metacarpal bones support the hand and form the knuckle at the back of the hand.
On a general basis metacarpal fractures are a result of any trauma that is caused to the hand by a forceful blow like in a fist fight, punch or karate chop. Sometimes a fall from the bike or car with hand grasping the bike handle or car steering wheel can also result in a metacarpal fracture.
Numbness, immediate swelling and intense pain in the metacarpal bones are the most common indications. Out of the five metacarpals the signs will be eminently present in the bone which is broken be it the first finger or the little finger or the thumb. The patient will also go through a limited range of movement with a popping sensation and instability in the metacarpal that has incurred the break.
The mechanism that causes the injury is an important tool for deducing the presence of possible metacarpal fractures along with radiography to confirm them. But CT and fluoroscopy are needed for deeper fractures such as Bennett’s or Rolando’s fracture which are otherwise not easily deducible.
Depending on the location of the fracture and the severity the fractures are treated by both nonsurgical and surgical techniques. The conservative treatment techniques involve reducing the bone and immobilizing it with a splint effectively for a few weeks and therapy exercises to enable right alignment and healing of the bone. Surgical treatment techniques are undertaken when a metacarpal fracture is severely displaced with multiple breaks damaging a tendon or ligament. Open reduction and internal fixation is relatively the technique which is adopted for these fractures and having them held together by pins, plates, K-wires or screws is an option chosen by the patient. Immobilizing the bone with splint, cast or external fixators and therapy exercises are important after care tools for surgical treatment to enable healing.
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