Articular fracture of the distal end segment
Definition
Partial and complete articular fractures of a metacarpal head are classified by the AO/OTA as 77.2–5.3B and C, respectively, where 2–5 indicates which metacarpal is injured.
Metacarpal head fractures may be simple but are often multifragmentary.
Further characteristics
These fractures are usually the result of an axial load to the hand. They often occur from punching a hard object, such as a wall or an opponent.
Always be aware of the potential of this being an open fracture due to contact with the oral cavity and the risk of severe infection.
Imaging
X-rays
The degree of displacement and the number of fragments may be difficult to judge on standard x-rays.
This case shows a palmar coronal fracture of the 4th metacarpal head.
CT imaging
CT scans help evaluate the degree of displacement and the number of fragments.
This is an image of the case above.
