Complete articular fracture of the proximal end segment

Complete articular fractures of a metacarpal base are classified by the AO/OTA as 77.2–5.1C, where 2–5 indicates which metacarpal is injured.

The 5th metacarpal is a common site for metacarpal base fractures.

Most of these fractures are comminuted and impacted and are often associated with carpometacarpal fracture-dislocations.

Additional dorsal shearing fractures of the hamate may be present.

Fractures of the 5th metacarpal base may be associated with a carpometacarpal dislocation of the 4th ray.

Occasionally, there is a subluxation of the 3rd or even the 2nd metacarpal, and any combination with additional fractures can be seen.

AP, lateral, and oblique views should be obtained.

CT scans are very helpful in determining the number, size, and position of the fragments.