Metacarpal Fractures

Metacarpal fractures are breaks in one or more of the long bones of the hand that connect the wrist to the fingers. These injuries are common and often occur following a direct blow, fall, or twisting injury.

The fifth metacarpal (little finger side) is most frequently affected, often referred to as a “boxer’s fracture.” Depending on the severity and alignment of the fracture, treatment may be non-surgical or require operative fixation.

Early diagnosis and appropriate management are important to restore hand function and prevent long-term stiffness or deformity.

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Diagnosis is based on:

• Clinical examination
• X-rays to assess fracture pattern and alignment

In complex cases:

• CT scans may be used

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Treatment depends on the type and severity of the fracture.

Non-surgical treatment may include:

• Immobilisation in a splint or cast
• Pain management
• Activity modification

Surgical treatment may be required if:

• The fracture is displaced or unstable
• There is rotational deformity
• Multiple bones are involved

Procedures may involve fixation with wires, screws, or plates to restore alignment

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Surgical treatment may involve:

• Realignment of the fracture
• Fixation using wires, screws, or plates

This is usually performed under regional or general anaesthetic.

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Recovery typically includes:

• Immobilisation for several weeks
• Gradual mobilisation and physiotherapy
• Hand therapy to restore strength and function

Full recovery may take several weeks to months.

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Possible complications of treatment include:

• Infection (rare)
• Stiffness of the fingers or hand
• Malunion or deformity
• Tendon irritation or adhesion
• Hardware-related irritation (if surgery performed)

Careful rehabilitation helps minimise these risks.

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You should seek medical attention if:

• You have significant hand pain following an injury
• There is visible deformity or swelling
• You cannot grip or move your fingers normally

Early assessment helps ensure proper healing and function.

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