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The neck of a metacarpal is a common location for a boxer's fracture, but all parts of the metacarpal bone (including head, body and base) are susceptible to fracture. During their lifetime, 2.5% of individuals will experience at least one metacarpal fracture. Bennett's fracture (base of the thumb) is the most common. [4]
The first metacarpal bone is short and thick with a shaft thicker and broader than those of the other metacarpal bones. Its narrow shaft connects its widened base and rounded head; the former consisting of a thick cortical bone surrounding the open medullary canal; the latter two consisting of cancellous bone surrounded by a thin cortical shell.
It presents on its base one facet on its superior surface, which is concavo-convex and articulates with the hamate, and one on its radial side, which articulates with the fourth metacarpal. On its ulnar side is a prominent tubercle for the insertion of the tendon of the extensor carpi ulnaris muscle.
The metacarpal bone of the index finger has two centres of ossification: a primary centre in the shaft and a secondary centre in the head. This contrasts to the first metacarpal bone where the secondary centre is found in the base. The ossification process begins in the shaft during prenatal life, and in the head between 11th and 22nd months. [4]
Metacarpal neck fracture of the little finger, scrapper's fracture, [1] bar room fracture, street fighter's fracture [1] Boxer's fracture of the 5th metacarpal head from punching a wall: Specialty: Emergency medicine, orthopedics: Symptoms: Pain, depressed knuckle [2] Causes: Hitting an object with a closed fist [3] Diagnostic method
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The third metacarpal bone (metacarpal bone of the middle finger) is a little smaller than the second.. The dorsal aspect of its base presents on its radial side a pyramidal eminence, the styloid process, which extends upward behind the capitate; immediately distal to this is a rough surface for the attachment of the extensor carpi radialis brevis muscle.
The base is small and quadrilateral; its superior surface presents two facets, a large one medially for articulation with the hamate, and a small one laterally for the capitate. On the radial side are two oval facets, for articulation with the third metacarpal; and on the ulnar side a single concave facet, for the fifth metacarpal.