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KEY FACTS
Terminology
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Dislocation: complete dissociation of articular surfaces
- Subluxation: partial dissociation of articular surfaces
- Fracture types
- Boxer's fracture: 4th or 5th metacarpal (MC) neck fracture; MC head volar angulation
- Misnomer: perhaps better called brawler's fracture, since professional boxer punches with greater force at 2nd and 3rd ray
- Epibasal thumb fracture: stable 2-part transverse fracture of proximal 1st MC
- Bennett fracture: oblique intraarticular fracture of 1st MC base, resulting in small triangular volar lip fragment
- Rolando fracture: intraarticular comminuted 1st MC base fracture
- Often forms Y- or T-shaped configuration
- Fight bite: opponent's tooth breaks skin over MCP joint with injury to dorsal capsule ± extensor tendon ± MC head
- Boxer's fracture: 4th or 5th metacarpal (MC) neck fracture; MC head volar angulation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Mechanisms of Injury
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
- Soong M et al: Metacarpal fractures in the athlete. Curr Rev Musculoskelet Med. 10(1):23-7, 2017
- Cotterell IH et al: Metacarpal and phalangeal fractures in athletes. Clin Sports Med. 34(1):69-98, 2015
- Gehrmann SV et al: Fracture-dislocations of the carpometacarpal joints of the ring and little finger. J Hand Surg Eur Vol. 40(1):84-7, 2015
- Cano Gala C et al: Fracture of the body of hamate associated with a fracture of the base of fourth metacarpal: a case report and review of literature of the last 20 years. Int J Surg Case Rep. 4(5):442-5, 2013
- Sletten IN et al: Assessment of volar angulation and shortening in 5th metacarpal neck fractures: an inter- and intra-observer validity and reliability study. J Hand Surg Eur Vol. 38(6):658-66, 2013
- Fufa DT et al: Fractures of the thumb and finger metacarpals in athletes. Hand Clin. 28(3):379-88, x, 2012
- Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
- Wessely K et al: Ultrasound findings of the locked metacarpophalangeal joint. Skeletal Radiol. 38(1):85-9, 2009
- Al-Qattan MM: The triad of multiple metacarpal fractures and/or dislocations of the fingers, severe hand swelling and clinical evidence of acute median nerve dysfunction. J Hand Surg Eur Vol. 33(3):298-304, 2008
- Leggit JC et al: Acute finger injuries: part II. Fractures, dislocations, and thumb injuries. Am Fam Physician. 73(5):827-34, 2006
- Dillon J et al: Divergent dislocation of the ring and little finger carpometacarpal joints--a rare injury pattern. Acta Orthop Belg. 71(3):353-6, 2005
- Daniels JM 2nd et al: Hand and wrist injuries: Part II. Emergent evaluation. Am Fam Physician. 69(8):1949-56, 2004
- Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
- Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004
- Lawlis JF 3rd et al: Carpometacarpal dislocations. Long-term follow-up. J Bone Joint Surg Am. 73(1):52-9, 1991
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Dislocation: complete dissociation of articular surfaces
- Subluxation: partial dissociation of articular surfaces
- Fracture types
- Boxer's fracture: 4th or 5th metacarpal (MC) neck fracture; MC head volar angulation
- Misnomer: perhaps better called brawler's fracture, since professional boxer punches with greater force at 2nd and 3rd ray
- Epibasal thumb fracture: stable 2-part transverse fracture of proximal 1st MC
- Bennett fracture: oblique intraarticular fracture of 1st MC base, resulting in small triangular volar lip fragment
- Rolando fracture: intraarticular comminuted 1st MC base fracture
- Often forms Y- or T-shaped configuration
- Fight bite: opponent's tooth breaks skin over MCP joint with injury to dorsal capsule ± extensor tendon ± MC head
- Boxer's fracture: 4th or 5th metacarpal (MC) neck fracture; MC head volar angulation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Mechanisms of Injury
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
- Soong M et al: Metacarpal fractures in the athlete. Curr Rev Musculoskelet Med. 10(1):23-7, 2017
- Cotterell IH et al: Metacarpal and phalangeal fractures in athletes. Clin Sports Med. 34(1):69-98, 2015
- Gehrmann SV et al: Fracture-dislocations of the carpometacarpal joints of the ring and little finger. J Hand Surg Eur Vol. 40(1):84-7, 2015
- Cano Gala C et al: Fracture of the body of hamate associated with a fracture of the base of fourth metacarpal: a case report and review of literature of the last 20 years. Int J Surg Case Rep. 4(5):442-5, 2013
- Sletten IN et al: Assessment of volar angulation and shortening in 5th metacarpal neck fractures: an inter- and intra-observer validity and reliability study. J Hand Surg Eur Vol. 38(6):658-66, 2013
- Fufa DT et al: Fractures of the thumb and finger metacarpals in athletes. Hand Clin. 28(3):379-88, x, 2012
- Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
- Wessely K et al: Ultrasound findings of the locked metacarpophalangeal joint. Skeletal Radiol. 38(1):85-9, 2009
- Al-Qattan MM: The triad of multiple metacarpal fractures and/or dislocations of the fingers, severe hand swelling and clinical evidence of acute median nerve dysfunction. J Hand Surg Eur Vol. 33(3):298-304, 2008
- Leggit JC et al: Acute finger injuries: part II. Fractures, dislocations, and thumb injuries. Am Fam Physician. 73(5):827-34, 2006
- Dillon J et al: Divergent dislocation of the ring and little finger carpometacarpal joints--a rare injury pattern. Acta Orthop Belg. 71(3):353-6, 2005
- Daniels JM 2nd et al: Hand and wrist injuries: Part II. Emergent evaluation. Am Fam Physician. 69(8):1949-56, 2004
- Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
- Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004
- Lawlis JF 3rd et al: Carpometacarpal dislocations. Long-term follow-up. J Bone Joint Surg Am. 73(1):52-9, 1991
