Non-thumb metacarpal fracture (base): Difference between revisions
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==Background== | ==Background== | ||
*Reverse Bennett: fracture of fifth metacarpal base, with extensor carpi ulnaris traction on distal metacarpal while proximal fragment still algined with carpals | *Reverse Bennett: fracture of fifth metacarpal base, with extensor carpi ulnaris traction on distal metacarpal while proximal fragment still algined with carpals | ||
** See [[Thumb fracture]] for Bennett fracture | **See [[Thumb fracture]] for Bennett fracture | ||
==Clinical Features== | ==Clinical Features== | ||
Latest revision as of 16:17, 27 October 2016
Background
- Reverse Bennett: fracture of fifth metacarpal base, with extensor carpi ulnaris traction on distal metacarpal while proximal fragment still algined with carpals
- See Thumb fracture for Bennett fracture
Clinical Features
- Movement at the wrist elicits pain
- Assess for ulnar deficits (finger abduction/adduction)
- Assess for rotational alignment
Differential Diagnosis
Hand and Finger Fracture Types
Evaluation
- Xray hand: AP, lateral, oblique
- 30 deg obliques pronated and supinated if usual films unable to visualize the MC bases
- Consider CT if index of suspicion high for occult fracture despite "negative" plain films
Management
- Dorsal and Forearm Volar Splint with the wrist in 30 deg of extension and MCP joints free
Disposition
- Refer for:
- Intraarticular fracture
- Extraarticular fracture with malrotation
- Dislocation of metacarpal base CMC joint;
- Ulnar nerve injury
- 5th metacarpal base fracture (typically require surgery)