Extraarticular fracture of the distal end segment

Subcapital or neck fractures of a metacarpal are classified by the AO/OTA as 77.2–5.3A, where 2–5 indicates which metacarpal is injured.

The fracture pattern may be transverse, oblique, or multifragmentary.

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.

AP, lateral, and oblique views should be obtained.

In the AP view, deformity, comminution, and shortening can be evaluated compared to the other metacarpals.

In the lateral view, flexion deformity can be evaluated.

This AP x-ray shows a subcapital/neck fracture of the 5th metacarpal.

The oblique view of the same case demonstrates the angulation of the neck fracture.