Sagittally Oriented Fifth Metacarpal Head Fracture with Extension into the Fifth Metacarpal Neck and Nondisplaced Shear Fracture of the Fourth Metacarpal Head

Metacarpal head fractures are uncommon fractures. A comprehensive review by McEl-fresh and Dobyns revealed an array of metacarpal head fracture patterns they classified into 10 types based on anatomic involvement as seen on roentgenographs examination: (1) epiphyseal, (2) collateral ligament avulsion injuries, (3) osteochondral,

5th Metacarpal Head Fracture Picture
Figure 44—1. Radiograph ofnondisplaced shear fracture of the fourth metacarpal head and a displaced sagittal fracture of the head of the fifth metacarpal.
4th And 5th Metacarpal Fracture

Figure 44—2. A stable fourth metacarpal head fracture and displaced fracture of the head of the fifth metacarpal.

(4) oblique (sagittal), (5) vertical (coronal), (6) horizontal (transverse), (7) comminuted, (8) intraarticular extension (in boxers), (9) loss of substance, and (10) avascular necrosis. Of these types, comminuted fractures were the most common (31%).

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