Metacarpal Fractures
Metacarpal fractures affect the bones of the hand and can result from direct trauma. Timely care is crucial to restore grip strength and hand function. The hand and upper extremity specialists at The Hand, Wrist, and Elbow institute with offices in Chicago, Illinois and the surrounding regions provide expert diagnosis and personalized care for metacarpal fractures using advanced surgical and nonsurgical treatments followed by individualized rehabilitation. Call The Hand, Wrist and Elbow institute to make an appointment at any one of our convenient locations and experience state-of-the-art care with compassion.
What is a Metacarpal Fracture?
A metacarpal fracture is a break in one of the five long bones of the hand that connect the wrist (carpal bones) to the fingers. These bones are responsible for the structure and movement of the hand, and fractures can significantly impact grip strength and hand function. The most commonly fractured metacarpal is the fifth, which connects to the little finger—a type often referred to as a “boxer’s fracture.”
Causes of Metacarpal Fractures
Metacarpal fractures typically result from direct trauma or forceful impact to the hand. Common causes include:
- Punching a hard object, such as a wall or another person (especially in boxer’s fractures)
- Falls onto an outstretched hand
- Crushing injuries, such as those from machinery or heavy objects
- Sports injuries, especially in contact sports like football or martial arts
- Motor vehicle accidents that involve hand impact
The location and pattern of the fracture can vary depending on the direction and amount of force applied.
What are the Symptoms of a Metacarpal Fracture?
Metacarpal fractures often produce noticeable signs and symptoms. These may include:
- Pain and swelling in the hand or at the base of the affected finger
- Bruising or discoloration
- Visible deformity or angulation of the finger or hand
- Tenderness when touching or moving the hand
- Limited range of motion or inability to make a fist
- Knuckle depression, especially in boxer’s fractures
How is a Metacarpal Fracture Diagnosed?
Diagnosis begins with a physical exam, focusing on swelling, tenderness, and range of motion. Imaging is used to confirm the fracture:
- X-rays are the primary diagnostic tool and help determine the location, angle, and severity of the fracture.
- In complex or intra-articular fractures, a CT scan may be used for detailed assessment.
What are the Treatment Options for a Metacarpal Fracture?
Treatment depends on the type, location, and displacement of the fracture. Common options include:
- Non-surgical care: Splinting or casting for stable, non-displaced fractures.
- Closed reduction: Realigning the bone manually under anesthesia, followed by immobilization.
- Surgery: Indicated for displaced, unstable, or multiple fractures—may involve pins, plates, or screws.
- Physical therapy: To restore strength, motion, and function after immobilization or surgery.