Back to Basics: First Metacarpal Fractures
Three types: Extra-articular, Intra-articular, Sesamoid Bone
1. Extra-articular Fracture
- Transverse
- Oblique
- Epiphyseal plate fracture (children)
Mechanism = Direct Blow
2. Intra-articular Base Fracture
- Bennett Fracture: fracture with subluxation or dislocation of the metacarpal joint
- Rolando Fracture: comminuted T or Y fracture involving joint surface
Mechanism = axial force directed against partially flexed metacarpal
Bennet Fracture (above)
Ronaldo Fracture (above)
3. Sesamoid Bone Fracture
- 3 sesamoids in thumb: two at MCP joint, one at IP joint
Mechanism = MCP Hyperextension
References:
Manthey, David E., and Kim Askew.. "Hand." Simon’s Emergency Orthopedics, 7eEd. Scott C. Sherman. New York, NY: McGraw-Hill, 2014.