Metacarpal fractures involve a fracture to the metacarpal bone, which is the long bone in the hand between the wrist and fingers. Metacarpal fractures may be simple or complex. Simple fractures can be managed by splinting or casting, whereas more complex fractures require surgery.  

What causes metacarpal fractures? 

Metacarpal fractures can be caused by a fall on an outstretched hand, a heavy object falling onto the hand or axial load such as a punch movement.  

What are common types of metacarpal fractures?

The most common type of metacarpal fracture is fracture of the 5th metacarpal head, or also known as a Boxer’s fracture. It accounts for 40% of all hand fractures. Boxer’s fracture is commonly caused by an axial pressure applied with a clenched fist such as punching.  

Another common metacarpal fracture is fracture to the base of the first metacarpal bone, located at the base of the thumb. This is commonly known as a Bennett’s fracture. They can be an unstable fracture and can dislocate at the CMC joint. This is due to the pull of the muscles and the ligament.  

What are the symptoms?

  • Pain in the hand, especially near the big knuckles on the back of the hand
  • Swelling
  • Loss of movement in the finger or knuckle
  • Loss of movement in the angulation of the finger when trying to close a fist

How are metacarpal fractures treated?  

Metacarpal fractures require immobilisation in a thermoplastic splint, which is custom made by one of our therapists. Treatment also includes tendon gliding exercises, oedema management and strengthening when fracture has healed.  

If the fracture has been fixed via surgery, you will need to see a hand therapist within a few days to commence range of movement exercises, have a custom-made splint fabricated and for wound care.