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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.
[3] [5] The third (middle finger) metacarpal head has been reported to be the most common site of necrosis. [6] Though osteonecrosis is a fairly common condition, many cases of avascular necrosis of the metacarpal head go without being diagnosed. This is because presentation of symptoms is variable depending on the patient.
A boxer's fracture is the break of the fifth metacarpal bone of the hand near the knuckle. [4] Occasionally, it is used to refer to fractures of the fourth metacarpal as well. [1] Symptoms include pain and a depressed knuckle. [2] Classically, it occurs after a person hits an object with a closed fist. [3]
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]
A fracture of the fourth and/or fifth metacarpal bones transverse neck secondary due to axial loading is known as a boxer's fracture. [1] [[[Boxer%27s_fracture#{{{section}}}| contradictory]]] The fifth metacarpal bone is the most common bone to be injured when throwing a punch.
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The metacarpophalangeal joints (MCP) are situated between the metacarpal bones and the proximal phalanges of the fingers. [1] These joints are of the condyloid kind, formed by the reception of the rounded heads of the metacarpal bones into shallow cavities on the proximal ends of the proximal phalanges. [1]