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Metacarpal fractures are usually caused by the impact of a clenched fist with a hard, immovable object, such as a skull or a wall. [6] When a punch impacts with improper form, the force occurs at an angle towards the palm, creating a dorsal bend in the bone, ultimately causing the fracture when the bone is bent too far.
The angulation goes between: [1] A line drawn between the distal ends of the articular surface of the radius on a lateral X-ray. A line that is perpendicular to the diaphysis of the radius. Sometimes, the diaphysis of the radius is hard to distinguish from the ulna, and a line between them (turquoise line in image) may be used instead. [2]
Significant angulation and deformity may require an open reduction and internal fixation or external fixation. The volar forearm splint is best for temporary immobilization of forearm, wrist and hand fractures, including Colles fracture.
The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones.. The CMC joint of the thumb or the first CMC joint, also known as the trapeziometacarpal (TMC) joint, differs significantly from the other four CMC joints and is therefore described separately.
The metacarpophalangeal joints (MCP) are situated between the metacarpal bones and the proximal phalanges of the fingers. [1] These joints are of the condyloid kind, formed by the reception of the rounded heads of the metacarpal bones into shallow cavities on the proximal ends of the proximal phalanges. [1]
The index metacarpal is the most firmly fixed, while the thumb metacarpal articulates with the trapezium and acts independently from the others. The middle metacarpals are tightly united to the carpus by intrinsic interlocking bone elements at their bases. The ring metacarpal is somewhat more mobile while the fifth metacarpal is semi ...
The intermetacarpal joints are in the hand formed between the metacarpal bones. The bases of the second, third, fourth and fifth metacarpal bones articulate with one another by small surfaces covered with cartilage. The metacarpal bones are connected together by dorsal, palmar, and interosseous ligaments.
A collateral ligament flanks each MCP joint - one on either side. Each attaches proximally at the head of the metacarpal bone, and distally at the base of the phalynx. Each extends obliquely in a palmar direction from its proximal attachment to its distal attachment. [2]