Metacarpal Fracture/Break – Head, Shaft, Base: A Comprehensive Guide

What is a Metacarpal Fracture?

A metacarpal fracture is a break or crack in one of the five long bones in the hand, called the metacarpals. These bones connect the wrist (carpals) to the fingers (phalanges) and play a crucial role in hand function, enabling movement, grip, and dexterity. Metacarpal fractures are common hand injuries, often resulting from falls, direct trauma, or high-impact activities such as sports.

Anatomy of the Metacarpal Bones

The metacarpal bones are the long bones in the hand located between the wrist (carpal bones) and the fingers (phalanges). There are five metacarpal bones, each corresponding to a finger:

• Metacarpal I: The thumb
• Metacarpal II: The index finger
• Metacarpal III: The middle finger
• Metacarpal IV: The ring finger
• Metacarpal V: The little finger

Each metacarpal has three parts:

• Head: The rounded end near the knuckle, forming the joint with the phalanges.
• Shaft: The long, middle part of the bone.
• Base: The end of the metacarpal closest to the wrist, forming joints with the carpal bones.

Types of Metacarpal Fractures

1. Head Fractures

These fractures occur at the rounded end of the metacarpal, near the knuckle. They are typically caused by direct impact or a fall onto a closed fist. Head fractures can affect the joint surface, leading to potential long-term stiffness or arthritis if not properly treated.

2. Shaft Fractures

Shaft fractures happen along the long, central part of the metacarpal. They are among the most common metacarpal fractures and can vary widely in severity, from minor cracks to complete breaks. Shaft fractures can be further classified as transverse (horizontal), oblique (angled), or spiral (twisted), depending on the fracture line.

3. Base Fractures

Base fractures occur at the end of the metacarpal closest to the wrist. These fractures may involve the joint where the metacarpal meets the carpal bones. Base fractures can lead to instability if the joint is affected and often require careful alignment and possibly surgery to restore function.

How Common Are Metacarpal Fractures?

Metacarpal fractures are among the most frequent hand injuries, accounting for around 30-40% of all hand fractures. They are especially common in young, active individuals and are often associated with high-impact sports, accidents, and occupational injuries.

Summary

Metacarpal fractures are common injuries that vary depending on the location (head, shaft, or base) and mechanism of injury. Accurate diagnosis and treatment are essential to ensure proper healing and avoid complications, such as stiffness or impaired hand function.

Types of Metacarpal Fractures

Types of Metacarpal Fractures

Metacarpal fractures vary based on their location on the bone. Here’s a breakdown of the primary types:

1. Metacarpal Head Fractures

• Location: These fractures occur at the rounded end of the metacarpal near the knuckle (metacarpophalangeal joint).
• Mechanism of Injury: Often result from a direct impact to the knuckle area, such as from punching a hard surface or a fall on an outstretched hand.
• Characteristics: Metacarpal head fractures may involve the joint surface, which can lead to long-term complications like stiffness, reduced range of motion, and arthritis if not correctly aligned and stabilised during healing.
• Treatment: Depending on the fracture’s complexity and displacement, treatment may involve immobilisation with a cast or, for severe fractures, surgical fixation.

2. Metacarpal Shaft Fractures

• Location: These fractures occur along the long, central part of the metacarpal bone.
• Types of Shaft Fractures:
  • Transverse: The fracture line is horizontal across the shaft.
  • Oblique: The fracture line is angled.
  • Spiral: The fracture line twists around the shaft, typically from a rotational force.
• Mechanism of Injury: Shaft fractures can result from direct trauma to the hand or a twisting injury.
• Characteristics: These fractures vary in severity, with some presenting as simple cracks, while others are complete breaks with bone displacement. Displaced fractures can cause rotational deformity, affecting hand function.
• Treatment: Many shaft fractures can be treated conservatively with splinting or casting, but significant displacement or rotation may require surgical intervention.

3. Metacarpal Base Fractures

• Location: These fractures occur at the end of the metacarpal closest to the wrist, near the carpometacarpal joint.
• Mechanism of Injury: Often caused by falls, motor vehicle accidents, or high-energy impacts.
• Characteristics: Base fractures may involve the joint between the metacarpal and the carpal bones, which can lead to joint instability if the alignment is disrupted. Fractures involving the joint surface are prone to post-traumatic arthritis if not properly managed.
• Treatment: Base fractures often require careful alignment, especially if the joint surface is involved. Severe cases may need surgical fixation to restore joint stability and function.

4. Boxer’s Fracture

• Location: A specific type of fracture that occurs at the neck of the fifth metacarpal, which connects to the little finger.
• Mechanism of Injury: Commonly results from punching a hard object with a closed fist, hence the name “Boxer’s Fracture.”
• Characteristics: Boxer’s fractures are typically transverse and may cause the head of the fifth metacarpal to angulate. In severe cases, this angulation can lead to a visible deformity of the knuckle.
• Treatment: Mild cases are often treated with a splint or cast. Significant angulation or displacement may require closed reduction (manipulation) or surgical fixation to restore hand alignment and prevent long-term dysfunction.

Each type of metacarpal fracture has unique characteristics that influence treatment options and potential outcomes. Prompt diagnosis and treatment are crucial for maintaining hand function and preventing complications.

Symptoms and Causes

What Causes Metacarpal Fractures?

Metacarpal fractures are typically caused by direct or indirect trauma to the hand. Common causes include:

1. Direct Impact or Trauma
   • Striking a hard object with a fist (as seen in Boxer’s fractures).
   • Contact sports or falls where the hand absorbs the force.
   • Motor vehicle accidents where the hand is crushed or impacted.
2. Twisting Injuries
   • Sudden rotational forces, especially common in sports or physical activities, can cause spiral fractures along the shaft of the metacarpal.
3. Compression or Crushing Forces
   • Heavy objects falling on the hand or situations where the hand is squeezed can cause fractures at the base or head of the metacarpal.

What Are the Risk Factors for Metacarpal Fractures?

Certain factors make individuals more susceptible to metacarpal fractures:

1. Sports Participation

High-impact and contact sports (e.g., boxing, martial arts, football, basketball) put athletes at greater risk of metacarpal fractures.

2. Occupational Hazards

Occupations that involve heavy manual labour or machinery increase the risk of hand trauma and subsequent fractures.

3. Falls and Physical Activity

Activities with a risk of falls or rapid movements, such as cycling or skiing, are common sources of hand injuries.

4. Bone Health

Conditions like osteoporosis or nutritional deficiencies can weaken bone structure, increasing fracture risk with even minor trauma.

5. High-Risk Behaviours

Engaging in physical confrontations or striking hard objects with a closed fist can lead to fractures, especially the common “Boxer’s fracture.”

What Are the Symptoms of a Metacarpal Fracture?

Metacarpal fracture symptoms vary depending on the location and how severe the injury is but generally include:

• Pain and Tenderness: Localised pain at the fracture site, worsening with movement.
• Swelling: Swelling around the fracture area, which can extend to the fingers.
• Bruising: Discolouration around the injury site, often appearing after a few hours.
• Deformity: Visible deformity or misalignment, especially in displaced fractures.
• Reduced Mobility: Difficulty moving the fingers or gripping objects.
• Knuckle Depression: In Boxer’s fractures, the knuckle may appear sunken.

Head Fracture Symptoms

• Pain and swelling around the knuckle.
• Difficulty flexing the finger associated with the fractured metacarpal.
• Tenderness and possible dislocation at the joint if the fracture extends into it.

Shaft Fracture Symptoms

• Sharp pain along the shaft, especially when pressure is applied.
• Swelling and bruising along the length of the metacarpal.
• Possible rotation or angular deformity of the finger when making a fist.

Base Fracture Symptoms

• Pain and swelling near the wrist or base of the hand.
• Limited wrist movement or instability if the carpometacarpal joint is involved.
• In severe cases, an obvious deformity near the base of the metacarpal.

What Are the Complications of Untreated Metacarpal Fractures?

Leaving a metacarpal fracture untreated or improperly treated can lead to complications, including:

1. Malunion or Deformity

Without proper alignment, the bones can heal in a misaligned position, resulting in visible deformity, finger rotation, or an altered hand shape.

2. Reduced Grip Strength and Function

Malaligned or improperly healed fractures can weaken grip strength, affect dexterity, and limit hand movements, impacting daily tasks.

3. Joint Stiffness and Reduced Mobility

Untreated fractures, particularly at the head or base near joints, may lead to stiffness, limiting the range of motion and causing chronic pain.

4. Chronic Pain and Arthritis

Fractures involving joints or those that heal improperly can lead to post-traumatic arthritis, which causes ongoing joint pain and inflammation.

5. Nerve or Blood Vessel Damage

Severe fractures can compress or damage surrounding nerves and blood vessels. This can cause numbness, tingling, or poor blood circulation in the fingers.

6. Functional Impairment

Complications from untreated fractures can hinder the hand’s ability to perform fine motor skills, leading to limitations in activities requiring precision.

Early treatment of metacarpal fractures is crucial to avoid these complications, ensure proper alignment, heal, and restore hand function. Access Ortho specialises in diagnosing and treating fractures, sprains, strains, and dislocations. It is an Orthopaedic surgeon-led urgent care clinic offering rapid appointments for immediate assessment and follow-up care in the clinic. 

Diagnosis and Tests

How Are Metacarpal Fractures Diagnosed?

Metacarpal fractures are typically diagnosed through a combination of physical examination and imaging tests. The diagnostic process helps determine the fracture’s type, location, and severity to guide appropriate treatment.

Physical Examination for Metacarpal Fractures

A medical practitioner will perform a thorough physical examination, focusing on the following:

1. Pain and Tenderness

The provider will palpate (press on) different areas of the metacarpals to localise pain and assess for tenderness over the fracture site.

2. Swelling and Bruising

Visible swelling or bruising indicates soft tissue damage around the fracture, helping the provider estimate injury severity.

3. Deformity

The provider will look for any obvious deformities or angulations in the hand or fingers, particularly when the hand is in a fist. Specific fractures, like Boxer’s fractures, may cause knuckle depression or rotational deformity.

4. Range of Motion

The provider tests the range of motion in the fingers and hand to assess any limitations caused by the fracture. The provider may also examine grip strength to evaluate hand function.

5. Neurovascular Check

The provider will check for any signs of nerve or blood vessel involvement, such as numbness, tingling, or weak pulses, as severe fractures can impact these structures.

Tests to Diagnose Metacarpal Fractures

Imaging studies are used to confirm a metacarpal fracture by identifying the precise location, fracture type, and alignment.

X-rays

• Purpose: X-rays are the primary imaging tool for diagnosing metacarpal fractures and are typically sufficient for most cases.
• Process: Standard hand X-rays provide multiple views (front, side, and oblique) to capture the fracture in different angles.
• Uses: X-rays help identify the fracture’s location (head, shaft, or base), the type of break (e.g., transverse, oblique, or spiral), and any displacement or misalignment.
• Specific Considerations:
  • Head Fractures: X-rays may reveal joint involvement or displacement, which is crucial for understanding potential complications.
  • Shaft Fractures: X-rays help identify any angulation or rotational deformity along the shaft.
  • Base Fractures: X-rays capture any joint involvement at the carpometacarpal joint, which may require special attention due to potential instability.

CT Scans (Computed Tomography)

• Purpose: CT scans are occasionally used when fractures are complex or if joint involvement is suspected but not clearly visible on X-rays.
• Process: CT scans provide cross-sectional images, offering detailed views of bone structures.
• Uses: CT scans are particularly useful for fractures involving multiple bones or those affecting the base or joints of the metacarpals. They allow for a more detailed view of fracture fragments and alignment.
• Specific Considerations:
  • Base Fractures: CT scans are often recommended for complex fractures near the carpometacarpal joint to better assess joint alignment and plan treatment.

MRI (Magnetic Resonance Imaging)

• Purpose: MRI is rarely used as a first-line test for metacarpal fractures but can be helpful in specific cases, especially if soft tissue injuries are suspected.
• Process: MRIs are machines that use magnetic fields and radio waves, creating detailed images of both bones and surrounding soft tissues.
• Uses: MRI is generally reserved for cases where there is concern about additional injuries, such as ligament tears, tendon injuries, or nerve damage, which can sometimes accompany fractures.
• Specific Considerations:
  • Head Fractures: If joint stability or ligament damage is suspected, an MRI may provide insight into surrounding soft tissue involvement.
  • Shaft and Base Fractures: MRI is rarely required for isolated shaft fractures but may be useful for base fractures with suspected ligament or soft tissue injuries.

This diagnostic process ensures a comprehensive understanding of the fracture, aiding in appropriate treatment and reducing the risk of complications. Orthopaedic Surgeons and Orthopaedic Nurse Practitioners are specialists in the care of fractures. Access Ortho offers rapid orthopaedic appointments for patients with known or suspected fractures. 

Management and Treatment

How Are Metacarpal Fractures Treated?

Metacarpal fractures are managed based on the type, location, and severity of the fracture. Treatment may range from conservative options to surgical intervention, with the goal of restoring hand function, reducing pain, and preventing complications.

Conservative Treatment Options

For less severe fractures, conservative treatment is often effective and may include:

1. Immobilisation Techniques
   • Immobilisation helps stabilise the fracture, allowing it to heal without movement that could disrupt alignment.
   • Splints: A splint may be used for minor fractures. It typically extends from the forearm to the fingers to immobilise the affected metacarpal.
   • Casts: For fractures with minimal displacement, a cast can offer more rigid support for a few weeks, helping maintain alignment and prevent further injury.
2. Pain Management
   • Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen help reduce pain and inflammation.
   • Ice Therapy: Applying ice can help reduce swelling and pain, especially in the first 48 hours.
   • Elevation: Elevating the hand can reduce swelling, promoting faster healing.

Surgical Interventions for Metacarpal Fractures

Surgery may be necessary for fractures that are displaced, unstable, or involve multiple fragments. Surgery aims to realign the bone, stabilise the fracture, and ensure proper healing.

Indications for Surgery

• Significant Displacement or Rotation: Fractures with more than 10-15 degrees of angulation or rotational deformities are candidates for surgery.
• Multiple Fractures: Surgery may be necessary for stabilisation in cases of complex or multi-metacarpal fractures.
• Open Fractures: Fractures that pierce the skin (open fractures) require surgical intervention to reduce infection risk and stabilise the bone.
• Joint Involvement: Fractures that extend into the joint space, such as those at the metacarpal head or base, often require surgery to prevent joint instability and arthritis.

Types of Surgical Procedures

1. Closed Reduction and Percutaneous Pinning

Used for fractures that are still minimally displaced but require some correction.

Pins are inserted through the skin to hold the bone in place. Once the fracture has stabilised, they are typically removed after a few weeks.

2. Open Reduction and Internal Fixation (ORIF)

This is a more invasive procedure involving an incision to access and align the fractured bones.

The surgeon uses screws, plates, or wires to secure the bone fragments and ensure proper alignment.

ORIF is commonly performed for complex fractures, especially those at the shaft or base, where alignment and stability are essential.

3. External Fixation

In cases of severe or open fractures, an external fixation device may be used. Metal pins are inserted into the bone on either side of the fracture. These are then connected to an external frame to stabilise the fracture.

This technique minimises disruption of soft tissues and is often used for complex or severely comminuted fractures.

Rehabilitation and Physiotherapy for Metacarpal Fractures

After immobilisation or surgery, rehabilitation and physiotherapy may be required to restore hand function, strength, and range of motion.

1. Early Mobilisation
   1. Once the bone has partially healed, guided exercises may begin to prevent stiffness and muscle atrophy.
   2. Flexion and extension exercises for the fingers are gradually introduced under the guidance of a physiotherapist.
2. Strengthening Exercises
   1. As healing progresses, grip-strengthening exercises are incorporated to restore hand strength and function.
   2. Resistance exercises, such as using putty or stress balls, help rebuild hand muscles.
3. Joint Mobilisation Techniques
   1. For fractures involving joints, specific exercises aim to regain full movement in the joints, reducing stiffness and promoting function.
4. Functional Training
   1. Focused on restoring everyday hand activities, functional training helps patients return to normal tasks, ensuring grip, dexterity, and coordination are regained.

With proper treatment and rehabilitation, most metacarpal fractures heal well, allowing a return to normal activities.

The Orthopaedic staff at Access Ortho will guide patients on whether conservative or surgical treatment is necessary. Access Ortho stocks casts on-site to immobilise injuries and can refer patients to nearby hand therapists if a custom cast is required. If surgery is required, Access Ortho will help arrange this. Non-surgical follow-up care is arranged in the Access Ortho Clinics with orthopaedic surgeons. 

Prevention

Preventing metacarpal fractures involves taking proactive steps to reduce the risk of trauma or excessive force on the hands. This is especially important for individuals involved in sports, manual labour, or activities that place a high demand on their hands.

How Can I Prevent Metacarpal Fractures?

1. Strength and Flexibility Training

Strengthening hand and wrist muscles through targeted exercises improves hand stability and resilience, helping to absorb impact forces and reduce injury risk.

Flexibility exercises, such as gentle stretches, can help keep the hands and fingers limber, reducing the risk of overstress or hyperextension.

2. Awareness of Surroundings

Avoiding sudden impacts or falls is crucial for fracture prevention. Being aware of hazards, such as slippery surfaces or loose objects, helps reduce the risk of falls and accidents.

Protective Equipment for High-Risk Activities

1. Sports-Specific Gear

For contact sports like boxing, martial arts, or hockey, wearing well-padded gloves can help absorb impact and prevent fractures. Gloves with reinforced padding protect the knuckles and metacarpal bones.

In sports like cycling or skateboarding, wrist guards can help protect against falls and absorb impact on the hand and wrist, reducing fracture risk.

2. Occupational Safety Equipment

People in construction or manual labour should use protective gloves to prevent crushing or impact injuries.

Gloves with reinforced materials can provide extra protection against heavy equipment, vibrations, and unexpected impacts.

Proper Technique in Sports and Daily Activities

1. Correct Punching Form in Combat Sports

When participating in boxing or martial arts, it’s essential to strike with proper alignment, hitting with the larger knuckles to reduce stress on the metacarpals and prevent fractures like Boxer’s fractures.

2. Using Safe Gripping Techniques

When lifting or handling heavy objects, proper gripping techniques can prevent excessive strain on the hands. Using the entire hand and engaging the forearms reduces stress on individual fingers and metacarpal bones.

3. Avoiding Direct Impact or Closed-Fist Strikes on Hard Surfaces

Refrain from punching hard surfaces or objects with a closed fist, as this is a common cause of fractures. Instead, use tools or adjust activities to reduce the need for direct hand impact.

Using protective gear, maintaining strength and flexibility, and practising proper techniques can significantly reduce the likelihood of metacarpal fractures and keep your hands safe and functional in high-risk activities.

Outlook / Prognosis for Metacarpal Fractures

Metacarpal fractures generally have a good prognosis, especially with appropriate treatment. With proper care, most individuals can regain full function of their hand, though recovery times and outcomes vary depending on the fracture’s location and severity.

What Can I Expect If I Have a Metacarpal Fracture?

Recovery from a metacarpal fracture typically involves immobilisation, pain management, and possibly physiotherapy. Most people can return to normal activities after the fracture heals, though some may experience temporary stiffness or reduced strength in the affected hand. Complicated fractures, such as those requiring surgery or involving multiple bones, may have a longer recovery and could affect hand function more significantly.

What Is the Recovery Time from a Fractured Metacarpal?

The recovery timeline varies based on the fracture type and treatment, but in general:

• Immobilisation Phase: 3 to 6 weeks for simple fractures, during which a cast or splint is often used.
• Rehabilitation Phase: An additional 4 to 6 weeks may be required to regain full strength, motion, and function.

Head Fracture Recovery

• Healing Time: 4 to 6 weeks, depending on fracture severity and joint involvement.
• Rehabilitation: May take longer if the fracture affects the joint, with focused exercises needed to restore range of motion and strength.

Shaft Fracture Recovery

• Healing Time: Generally 4 to 8 weeks, with possible longer immobilisation for displaced fractures.
• Rehabilitation: Focus on regaining grip strength and flexibility in the affected finger and hand.

Base Fracture Recovery

• Healing Time: 6 to 8 weeks, especially if the fracture extends into the carpometacarpal joint.
• Rehabilitation: Longer recovery and potentially more intensive physiotherapy may be required to ensure stability and full motion due to joint involvement.

Long-Term Outcomes and Potential Complications

Most people experience a full recovery; however, potential complications include:

• Stiffness: Reduced range of motion in the fingers or hand can occur, especially if rehabilitation is delayed.
• Weakness: Some may have residual weakness in the grip or affected fingers, particularly after severe fractures.
• Arthritis: Joint-involved fractures, especially at the head or base, may lead to early-onset arthritis, causing pain and stiffness over time.
• Malunion or Nonunion: In cases of improper healing, the bone may heal in a misaligned position (malunion) or fail to heal completely (nonunion), potentially requiring additional intervention.

Most metacarpal fractures heal well with minimal long-term effects with early intervention, proper immobilisation, and rehabilitation.

It is important to seek orthopaedic advice early to minimise complications. Access Ortho offers rapid appointments for urgent injuries helping to ensure an accurate diagnosis and treatment plan is established.

When to Seek Medical Attention

When Should I Go to a Fracture Clinic for a Potential Metacarpal Fracture?

If you suspect a metacarpal fracture—especially after experiencing trauma or force to the hand—it’s essential to visit a clinic that specialises in fracture care. Signs that suggest a fracture include intense pain, swelling, and trouble moving the hand or fingers. A fracture clinic such as Access Ortho provides specialised orthopaedic care, including imaging, diagnosis, and treatment plans to promote healing and restore function.

Red Flags: When Immediate Medical Attention Is Necessary

Seek urgent medical attention if you have any of the following symptoms, as they may indicate a more severe injury or complications requiring prompt care:

• Severe Pain: Pain that is unmanageable with over-the-counter pain relief or immobilisation.
• Visible Deformity: If the hand or finger appears visibly misaligned or if there is a protrusion of bone under the skin.
• Loss of Sensation: If the hand or fingers feel numb or are tingling, this could indicate nerve damage.
• Open Fracture: If the bone has broken through the skin, there is a high risk of infection, and immediate treatment is essential. If you have an open fracture, you need to attend your nearest Hospital Emergency Department. 
• Inability to Move Fingers or Hand: Complete loss of movement can signal a severe injury that needs immediate evaluation.
• Cold or Discoloured Skin: If the hand or fingers appear cold, pale, or blue, this could indicate compromised blood flow and require urgent care.

Addressing these red flags promptly can reduce the chance of complications and improve your outcome. Access Ortho only treats orthopaedic injuries, such as fractures, sprains, strains, and dislocations. Access Ortho staff are highly trained in treating orthopaedic injuries and offer immediate emergency care and follow-up care.

What is a Fracture Clinic?

A fracture clinic is a specialised healthcare facility or department within a hospital or clinic where patients with bone fractures, including metacarpal fractures, are assessed, treated, and monitored. These clinics are staffed by medical practitioners trained in orthopaedic injuries, offering expertise in diagnosing and managing musculoskeletal injuries.In the public setting, you may be referred to a public fracture clinic after attending the emergency department or your GP. Access Ortho is a private urgent care fracture clinic. Access Ortho offers immediate care and assessment of musculoskeletal injuries and follow-up care with orthopaedic surgeons. Access Ortho is an affordable alternative to EDs, Urgent Care and GPs and offers a full range of expert care for fractures, sprains, strains and dislocations.

Role of Fracture Clinics in Metacarpal Fracture Management

Fracture clinics such as Access Ortho play a crucial role in treating metacarpal fractures. They are designed to provide comprehensive care for bone injuries, including:

• Accurate Diagnosis: Fracture clinics utilise nearby specialised imaging (X-rays, CT scans, etc.) to accurately assess the fracture and determine the appropriate treatment plan.
• Initial Treatment: For simple fractures, the clinic provides immediate immobilisation, such as splinting or casting, to ensure proper healing.
• Surgical Evaluation: If the fracture is severe or displaced, the clinic can refer the patient for surgical intervention.
• Rehabilitation: Post-treatment, fracture clinics often recommend rehabilitation and physiotherapy to help restore hand function, strength, and flexibility.
• Follow-up Care: Regular follow-up visits ensure the fracture is healing properly, and adjustments to treatment can be made if necessary.

What to Expect During Your Fracture Clinic Visit

During a visit to a fracture clinic, you can expect the following steps:

1. Initial Assessment:

The doctor or orthopaedic Nurse Practitioner will take your medical history and ask about the injury mechanism (how the fracture occurred).

A physical examination of the injured hand will be conducted to check for deformities, swelling, and range of motion.

2. Imaging Studies:

X-rays are typically done to assess the extent and location of the metacarpal fracture. Additional imaging may be used in complex cases, for example a CT scan or MRI.

3. Treatment Plan:

The medical team will discuss treatment options based on the diagnosis. For simple fractures, you may be given a splint or cast. For more complicated fractures, surgical options, like pinning or ORIF (Open Reduction Internal Fixation), may be discussed.

Pain management, including recommendations for medications, will also be addressed.

4. Follow-up Schedule:

The clinic will provide follow-up appointments to monitor healing progress, typically involving repeat X-rays to ensure proper alignment and healing.

If surgery is required, the fracture clinic will help coordinate the procedure and referral. 

5. Rehabilitation Advice:
   1. Once the bone is healing, physiotherapy may be needed for early mobilisation exercises or to restore function and prevent stiffness.
   2. We will provide guidance on required post-treatment care, including advice on activity limitations and safe hand use.

By visiting a fracture clinic, you’ll receive specialised, ongoing care tailored to ensure optimal recovery and function of your hand. Access Ortho offers a simple option to get your orthopaedic acute injury assessed and treated rapidly. 

Commonly Asked Questions

Can I still move my finger if I have a metacarpal fracture?

It depends on the severity of the fracture. If the fracture is stable and not displaced, you may still be able to move your finger, but it may be painful and restricted. If the fracture is displaced or the joint is involved, movement may be severely limited.

How long does it take for a metacarpal fracture to heal?

The healing time for a metacarpal fracture ranges from 4 to 8 weeks, depending on the severity and location of the fracture. Simple fractures may heal more quickly, while complex fractures could take longer.

Will I need surgery for my metacarpal fracture?

Surgery may be necessary if the fracture is displaced, involves the joint, or if the bone cannot be properly aligned with a cast or splint. Surgical options include pinning or open reduction internal fixation (ORIF) to secure the bone in place. An orthopaedic surgeon is needed to make this decision.

What’s the difference between a boxer’s fracture and other metacarpal fractures?

A boxer’s fracture is a specific type of metacarpal fracture involving the fifth metacarpal (pinky) bone, typically caused by punching a hard object. This fracture often results in the bone being displaced, causing a characteristic “bend” in the finger.

Can I work with a metacarpal fracture?

If you need to do heavy lifting or manual tasks in your job, you may need time off to allow the fracture to heal properly. For office-based or less physically demanding work, you may be able to continue with modified duties, depending on the severity of the fracture and treatment plan.

How soon can I return to sports after a metacarpal fracture?

The return to sports will depend on the type of fracture, the healing process, and any surgical treatment. Most athletes can return after 6 to 8 weeks, but contact sports may require a longer recovery. Your doctor will provide a tailored timeline based on your injury.

Will my hand look different after a metacarpal fracture heals?

In some cases, the hand’s appearance may change, this is often seen if the fracture was severe or displaced. This could include mild deformities or reduced hand strength, though the hand should regain most of its function with proper treatment.

Are metacarpal fractures always painful?

Metacarpal fractures are typically painful, especially in the initial phase. However, the level of pain varies depending on the fracture’s severity and treatment. Swelling and bruising are also common.

Can a metacarpal fracture heal without treatment?

Some non-displaced fractures may heal on their own with proper rest and immobilisation. However, untreated fractures, particularly those that are displaced or involve the joint, can lead to complications like misalignment, arthritis, or loss of function, making treatment necessary.

What exercises can I do to regain strength after a metacarpal fracture?

Once your fracture has healed sufficiently, physiotherapy exercises will focus on restoring range of motion, grip strength, and hand coordination. Exercises may include finger stretches, hand grip exercises using putty or therapy balls, and gradual strengthening with resistance bands. Always consult with your doctor or physiotherapist before starting exercises.

Who should I see if I am worried I have a metacarpal fracture?

You should seek orthopaedic care if you have concerns about a hand injury. Access Ortho offers rapid appointments for acute injuries and is staffed by medical staff skilled in orthopaedics. Access Ortho also provides all follow-up care with our Orthopaedic Surgeons. Emergency Departments and Urgent Care centres can treat your immediate injury, but you will need to find orthopaedic follow-up care elsewhere. Access Ortho offers care from diagnosis to full recovery and can assist with surgery referrals if required.