Causes / typical injury mechanism: Metacarpal (MC) fractures typically result from a direct blow to the hand (eg, punching a wall) or a rotational injury with axial load. They can also occur in high-energy traumas such as automobile accidents.

Classic history and presentation: Patients with MC fractures typically present with hand pain, deformity, and a history of concomitant hand trauma.

MC fractures are commonly described by fracture location (head, neck, shaft, base; articular versus extraarticular). Among all MC fractures, those of the MC neck are the most common (ie, "boxer's fracture" of the fifth MC neck). Shaft fractures are also commonly encountered, while base and head fractures are relatively uncommon. Along with fracture location, other factors that guide management include which MC is injured, fracture geometry (transverse, spiral / oblique, or comminuted), deformity (angulation, rotation, shortening), open or closed fracture, presence of soft tissue injuries, and intrinsic fracture stability.

Prevalence: MC fractures are the most common fractures of the hand, accounting for 40% of all hand injuries.

• Age – Patients are most commonly between the ages of 10 and 45 years.
• Sex / gender – Most MC fractures occur in men (by a ratio of 3:1).

Related topic: thumb fracture