In the metacarpal area there are 5 metacarpal bones that connect the carpal bones with the finger bones. The whole hand consists of 27 bones. A metacarpal fracture (medical: metacarpal fracture) can occur as a result of severe physical exertion during sport, an accident or a fall.
What is a metacarpal fracture?
A metacarpal fracture is a break in the five metacarpal bones. There are different bones in the area of the metacarpal: the transition from the metacarpal to the finger bones is called the metacarpal head, the longer area is the shaft and the transition of the metacarpal, which connects the carpal and metacarpal, is called the base of the metacarpal. See ablogtophone for LMS which stands for Limb Mammary Syndrome.
Both open and closed fractures of one or more metacarpal bones can occur in all three areas. If the wound is open, a fractured bone and skin injury must be treated at the same time.
A metacarpal fracture can occur in any of the metacarpal bones. The fracture causes pain, bruising and swelling in the metacarpus and often also malpositions due to a shifted fracture site.
Metacarpal fractures can have various causes. Boxers are often affected by such fractures, but so are other athletes, especially those who have to grip an object with their hands.
It can happen to anyone in a fall if you fall unfavorably and break one or more metacarpal bones while catching yourself while falling.
Typical Symptoms & Signs
- hand pain
Diagnosis & History
An exact diagnosis can only be made with the help of an X-ray, which is displayed in different slices in order to be able to see how many bones are affected in the metacarpal fracture, whether the bones have shifted at the fracture site and how the fracture line runs.
Normally, no further examinations are necessary apart from the X-ray examination, because the fracture situation can be well assessed on the basis of the X-ray image.
If a metacarpal fracture has occurred, the hand should be immobilized and cooled immediately. If treated quickly, a metacarpal fracture will heal within a few weeks. The hand must be immobilized for the time of healing.
If the broken bone is not treated and grows together incorrectly, permanent damage can result, which can severely limit the mobility of the hand.
Those affected primarily suffer from severe pain as a result of the metacarpal fracture. The hand itself can usually no longer be moved, resulting in restricted movement and various restrictions in the patient’s everyday life. Bruising and swelling also occur in the affected region and the patients suffer from severe hand pain.
These can sometimes spread to the arm and lead to unpleasant symptoms there. Likewise, nocturnal pain can negatively affect sleep and lead to sleep disorders and further to depression. In order to avoid consequential damage or incorrect bone adhesions, a visit to the doctor is definitely necessary to prevent these symptoms.
As a rule, the metacarpal fracture is relatively easily healed and treated with the help of a plaster cast. There are no particular complications. In some cases, physiotherapy measures are also necessary to completely limit the symptoms and restore the movement of the hand. However, even after treatment of the fracture, sensory disturbances or paralysis of the hand can occur. The patient’s life expectancy is not reduced or restricted by this disease.
When should you go to the doctor?
A fracture of the metacarpal bone should usually always be treated by a doctor. Only those who opt for medical treatment can expect a full and timely recovery. Such a fracture is usually accompanied by severe and almost unbearable pain, so that those affected seek medical attention immediately.
Appropriate treatment can then be initiated as quickly as possible. In some cases, even a surgical intervention is possible to enable a complication-free healing. Things are different if there is only a hairline crack. This is a small tear in the bone that is not as painful as an existing fracture.
In many cases, affected people do not notice such a hairline crack at all, as it is accompanied by only minor pain. The range of motion is only restricted to a limited extent, so that there is often no suspicion of a fracture. The advantage: In most cases, such a crack in the bone heals completely independently and without medical care. In such a case, a visit to the doctor is not absolutely necessary. However, if there is a fracture of the bone, a visit to the doctor is mandatory to allow for complete healing.
Treatment & Therapy
A metacarpal fracture can be treated in different ways depending on the area affected. Head fractures or in the area around the head cannot be operated on. You will be straightened and then immobilized with a plaster cast for about 3 – 6 weeks. However, if bones are displaced more severely as a result of the metacarpal fracture, an operation on the fracture is necessary in order to rule out later damage.
Open fractures usually always have to be operated on because of the high risk of infection from an open wound. The course of healing can be monitored with X-ray examinations. In most cases, physiotherapy can be started cautiously a few days after the treatment in order to slowly restore the mobility and strength of the hand.
In most cases, the metacarpal fracture heals within a few weeks by immobilization with a plaster cast. Complications can sometimes occur with open fractures if the wound becomes inflamed or there is bleeding or wound healing problems. If the fracture is properly adjusted or operated on, there will be no malpositions or restricted mobility.
Swelling or numbness may initially occur or pain may occur when the weather changes, but this usually disappears a few months later. The mobility of the middle hand also only comes back gradually.
Outlook & Forecast
The prognosis of patients with metacarpal fractures is good in most cases. The fracture can be visible for a long time in the X-ray image, although new bone tissue forms after three weeks and the affected bone regains sufficient stability as a result. As soon as those affected no longer feel pressure pain in the fracture area, the broken hand can and should be moved intensively but without strain. After five weeks, you can slowly start to put weight on your hand again, taking your own pain limits into account.
If the fracture is treated quickly, it usually heals in just a few weeks. However, the hand should be absolutely still during the healing period. If the fracture is not treated and thus grows together incorrectly, long-term damage can occur, which particularly impairs the mobility of the hand.
In a few cases, physiotherapy is also necessary to completely eliminate the symptoms and, in particular, to restore mobility. However, even after treatment, sensory disturbances and even paralysis of the hand can occur. In some very rare cases, the metacarpal fracture does not heal as desired. The ends of the broken bone then do not grow back together and a “false joint” forms instead.
In most cases, metacarpal fractures cannot be prevented, except in certain sports. If there is a high risk of injury, the endangered areas should be optimally protected against the effects of violence. Most of the time, falls cannot be avoided because they happen suddenly and unconsciously, even if you are paying attention.
Special protective clothing is usually worn when skateboarding or inline skating, as well as in some sports such as football or rugby, in which the players are more at risk due to more intensive physical contact in the area of the hands.
In most cases, those affected with a metacarpal fracture have only a few and only limited direct follow-up measures available. For this reason, the person affected is primarily dependent on an early diagnosis so that other complications or symptoms do not arise in the further course. Self-healing cannot occur here, so that a doctor should be contacted in any case to ensure that the bones grow together properly.
First and foremost, unnecessary strain on the hand after immobilization with a cast should be avoided. In many cases, physiotherapy or physical therapy measures are also necessary to increase the mobility of the hand again. Many of the exercises from such therapies can also be carried out by the person concerned at home and thus accelerate healing.
If you experience numbness from a metacarpal fracture, it is advisable to consult a doctor as further treatment may be necessary. The disease usually does not reduce the life expectancy of the person affected, and no further measures of follow-up care are necessary.
You can do that yourself
A metacarpal fracture usually has to be treated by a doctor in any case. If medical treatment is not given, the bone can grow incorrectly, which can lead to pain and further complications.
If you break a metacarpal bone, go to a hospital immediately or call an ambulance if it was an accident. The healing of the fracture can be significantly accelerated by resting and resting the hand. The person concerned should refrain from strenuous activities or sports. The supply of trace elements and minerals can also have a positive effect on bone growth and healing. Most patients with this fracture also depend on therapy. With this can already a few days after plasteringbe started to fully restore hand mobility. The patient can also do various exercises at home.
For swelling or numbness, some patients need help from other people. As a rule, the relatives or friends of the person concerned should be there to support them. The life expectancy of the patient is usually not negatively affected by this injury.