Fifth Metacarpal Fracture

Fifth Metacarpal Neck Fracture ("Boxer's Fracture")

The mechanism of injury, examination, and radiographic findings confirm the diagnosis of a fifth metacarpal neck (or "boxer's") fracture. When applied to the fifth metacarpal, "boxer's fracture" is a misnomer because professional fighters are more likely to fracture their index and middle metacarpal necks. Breaking the small or

Dorsal Angulation Fracture

Figure 41—1. Posteroanterior

(PA) radiograph of the fifth metacarpal revealing metacarpal neck fracture with 60-degree apex dorsal angulation.

Figure 41—1. Posteroanterior

ring metacarpal neck is more often seen in weekend pugilists who use poor boxing technique.

The metacarpal neck is the most common site of fracture resulting from a clenched fist blow. Apex dorsal angulation occurs as a result of three factors:

1. The volar moment arm of the intrinsic muscles flexes the metacarpal head.

2. The force vector causing the fracture is from a dorsal to palmar direction.

3. Invariably, there is some degree of volar comminution at the fracture site.

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  • Vala
    How to diagnose fifth metacarpal break?
    5 years ago

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