Fifth Metacarpal Head Fracture is isolated, closed, stable injury, dislocation, break the base of the 5th metacarpal tubular bone either oblique, transverse, comminuted, spiral, complete, incomplete intra-articular fracture associated with axial loading compression of the extended digit movement or longitudinal forcefully compression in the base is most susceptible to fracture that causes the pain, swelling, hematoma, tenderness, and decreases the range of motion. Fractures of the metacarpal hesd destroy the stability of dorsal and palmar carpometacarpal ligaments as well as the interosseous ligaments. The interosseous muscles, collateral ligaments responsible for adduction and abduction of the fingers, originate from the metacarpal shafts and insert onto proximal phalanges. The tendon of the powerful extensor carpi ulnaris muscle attaches to the ulnar aspect of the fifth metacarpal base.
The metacarpal bone is no – 5, and one is the smallest of all five metacarpals bones of the hand. The metacarpal bone consists of a head (distally located), neck, body, and base (proximally located). Its base slightly differs from the other metacarpals bone of the hand. It presents on its base one facet on its superior surface, which is the concavo-convex shape and articulates with the hamate, and another surface on its radial side, which articulates with the fourth metacarpal at the base. On the ulnar side, its lateral part is non-articular and has a prominent tubercle for the insertion of the tendon of the extensor carpi ulnaris muscle, and articulates with the hamate bone. Body The dorsal surface of the body is divided by an oblique ridge, which extends from near the ulnar side of the base to the radial side of the head of the fifth metacarpal bone.
The lateral part of this surface inserts for the attachment of the fourth Interosseus dorsalis; the medial part is smooth, triangular, and covered by the extensor tendons of the little finger. The palmar surface is similarly divided into two, one lateral side (facing the fourth metacarpal) provides an origin for the third palmar interosseous, another one is the medial side contains the insertion of opponent digiti quinti muscle.
The proximal part of the lateral surface of the shaft articulates with the fourth metacarpal bone, while the medial surface serves to attach the opponent digit minimi muscle. The distal part of the lateral surface inserts the fibers from the fourth palmar and fourth dorsal interossei muscles. The fracture in the fifth metacarpal bone is commonly called the boxer fracture
Fifth Metacarpal Neck Fracture caused by longitudinal axial loading, axial loading on a partially metacarpal, clenched fist injuries, axial load via direct trauma to a clenched fist transfers energy to the metacarpal bone, falling on an extended, displacement of each fracture pattern can be angulated, translated, rotated, or shortened, an impact onto a clenched fist, direct blow, rotational movement, displacement of each fracture pattern can be angulated, translated, rotated, shortened, segmental fractures, crush injury, ceiling fan accident sudden uprighting hand, heavy impact of a car accident, bike accident, hitting hammer in the workshop, tight finger ring use, boxer playing, catching the ball when playing cricket, or a defensive goalkeeper in a football game, hitting, gunshot wound, sudden fall in outstretch hand, crush injury, projectile, sudden acceleration of the bike accelerator or clas, opening cran bottle, entrapment of the digit in a closing door, ligamentous laxity predisposes to hyper-extension, poor muscle attachment, osteoporosis, abnormal hormonal imbalance, etc.
Symptoms are intense pain, swelling, tenderness, bruising, laceration, deformity, edema, hematoma, restricted range of motion.
Classification
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Classification of fractures of the metacarpal
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Extra-articular oblique
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Oblique fracture line not involving the articular surface
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Extra-articular transverse
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Pure transverse fracture line not involving the articular surface
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Intra-articular Bennett
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Intra-articular fracture with a palmar ulnar fragment
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Intra-articular Rolando
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Y or T shaped complete intra-articular fracture
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Intra-articular comminuted
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Severely comminuted complete intra-articular fracture
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References
Fifth Metacarpal Neck Fracture
