Metacarpal fracture

How would this injury occur? 

The metacarpals are the bones of the palm of the hand.  Metacarpal fractures are a very common, making up 40% of all hand fractures. They usually occur following an accidental fall (such as onto a closed fist while running – like running holding a water bottle) or after a direct blow to the knuckles when punching (like sparring, boxing or martial arts). Fractures can occur to the head, neck, shaft or base of the metacarpal. A metacarpal neck fracture of the little finger is often called a boxers fracture. 

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What are the signs and symptoms? 

Symptoms include pain, swelling, and bruising over the back of the hand. It is common to be able to be able to move the fingers even when a metacarpal is fractured. Often the bruising and swelling occur quite quickly after the injury. 

Why is treatment important? 

Fractures of the metacarpal bones can lead to permanent changes in the shape and function of the hand if not correctly managed. You should not assume that your metacarpal isn’t fractured if you can still move your fingers. You should see a doctor or hand therapist to have your hand assessed and x-rayed to check for a fracture, especially if you have ongoing pain after an injury to your hand.

When should you see your Accredited Hand Therapist?

The sooner you are able to see your AHT the better! For a simple fracture your AHT will fit a custom made orthosis or cast for 4-6 weeks to immobilise the fracture and permit healing. You may be prescribed early controlled motion exercises. If there is a complicated fracture, where the bone has moved too far from the normal position, you may require surgery to improve alignment of the bone. In that case, your AHT can refer you to a specialist doctor. 

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Should I get an x-ray?

If you have had an x-ray, bring it to your first HT appointment. However, your AHT can send you for an x-ray, and may refer you to a specialist doctor, if required

How long until I play sport again?

Your AHT will determine when you can safely return to sport. Your therapist may make a playing splint if it is safe for early return to your sport after the period of fracture immobilisation. A complicated fracture, may be held back from sport for up to 12 weeks.

You can find a practitioner of Hand Therapy in your area by visiting the AHTA website home page and click on “Looking for an Accredited Hand Therapist?”. All you will need is your post code and you're on the way to having your sports hand injury treated wiht excellent care.