UMEM Educational Pearls

Category: Orthopedics

Title: Metacarpal Neck Fractures

Keywords: Metacarpal, Fracture, Boxer's Fracture (PubMed Search)

Posted: 2/2/2008 by Michael Bond, MD (Updated: 10/28/2020)
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Metacarpal Neck Fractures (i.e.: Boxer’s Fracture if 5th Metacarpal)

Depending on the MCP joint involved a certain amount of angulation is permissible before it adversely affects normal function.

  • 2nd and 3rd Metacarpal fractures < 10۫ angulation ideally these should be perfectly aligned.
  • 4th Metacarpal fracture <20۫ angulation allowed
  • 5th Metacarpal fracture <30۫ angulation. 
    • Studies have shown that even 30۫ angulation will decrease normal function by 20%.  
    • Normal excursion of the 5th MCP is 15۫ to 25۫.
  • No amount of rotation deformity should be allowed.