Metacarpal (Hand) Fracture

Description

A metacarpal is one of the long bones in the palm that connect the wrist to the fingers. These breaks are common; a frequent one is a fracture of the bone behind the small finger from striking something (a “boxer’s fracture”).

How it happens (the mechanism)

Metacarpals break from a direct blow, a punch, or a crush. The thing to watch is rotation: because the fingers fan out from these bones, a small twist at the break becomes a noticeable crossing-over of the finger when the hand makes a fist. Angles often remodel and forgive; rotation does not.

Symptoms

Pain, swelling, and bruising over the back of the hand, sometimes with a knuckle that looks flattened or a finger that points oddly when curled.

Doctor examination and imaging

The doctor checks alignment and, importantly, finger rotation with the hand gently curled. X-rays show the fracture and its angle.

Treatment

Most heal in a cast or splint for three to four weeks. A significantly bent or twisted fracture is straightened first, and a small number need a pin to hold the alignment.

Recovery and long-term outlook

Hand fractures in children heal well; making sure the finger lines up correctly when curled is what ensures a normal-working hand.

When to call the doctor

Call the office right away if your child’s fingers become numb, pale, blue, or cold; pain keeps worsening even after raising the arm and giving medicine; swelling does not improve with elevation; the cast feels too tight, cracked, or wet, or smells bad; or your child develops a fever.

Learn more

OrthoInfo (AAOS) — Growth Plate Fractures: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.