Wedge or multifragmentary fracture of the diaphysis

Wedge and multifragmentary fractures of a metacarpal shaft are classified by the AO/OTA as 77.2–5.2B and C, respectively, where 2–5 indicates which metacarpal is injured.

Comminuted fractures often result from crushing or high-energy injuries and may involve several metacarpals.

Compartment syndrome may occur with these types of injuries, and fasciotomy may be necessary.

These fractures tend to be very unstable.

Most of these fractures produce a flexion deformity and often minimal shortening.

AP, lateral, and oblique views should be obtained.

In the AP view, any shortening can be evaluated in comparison with the other metacarpals.

In the lateral view, flexion deformity will be visible.

AP view of the metacarpals with multifragmentary fractures of multiple metacarpals

AP view showing a spiral or wedge fracture of the 4th metacarpal