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Metacarpal fracture is a broken bone (fracture) in the middle of the hand. The metacarpal bones connect the wrist to the fingers and make up the arch of the hand. One or more metacarpal bones may be fractured. Fracture of the metacarpal of the little finger is most often near the knuckle. This is called a boxer's fracture.
These bones are stable when only one is broken, so single bone fractures are often treated without surgery when they do not involve the joint and are not displaced (out of alignment). If the bones are in the correct position, the treatment consists of ice and elevation of the injured hand at or above heart level to reduce swelling. Immobilization by splinting, bandaging, casting, or bracing for 4 or more weeks is usually recommended to protect the bones while they heal.
For fractures that are displaced (out of alignment), involve more than one metacarpal, or involve a joint (the knuckle or the wrist) and are displaced, surgery is usually recommended. Surgery usually involves placement of removable pins, screws, and occasionally plates. After immobilization (with or without surgery), stretching and strengthening of the injured and weakened joint and surrounding muscles (due to the immobilization and the injury) are necessary. These may be done with or without the assistance of an occupational therapist, physical therapist, or athletic trainer. Occasionally, depending on the sport and position, a brace or splint may be necessary when initially returning to sports.
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