Fractures of the fifth metacarpal

The literature is limited concerning the epidemiological issues of fracture in the fifth metacarpal bone.

To explore the incidence and types of this fracture, and how the fracture is related to age, gender, trauma mechanism, and at what day of the week the causing trauma occurred.

All hand fractures registered at the Department of Radiology, Buskerud Hospital, Norway, in the period between 2004 and 2006 were reviewed.

Of 1475 hand fractures, 271 (18.4%) were located in the fifth metacarpal bone. In 130 of these cases (121 male, nine female), the trauma had occurred through aggression, such as a fistfight or from punching a hard object. The majority of fractures were located in the neck of the metacarpal bone (boxer's fracture). The median age of this group was 22 (7-51) years. Concerning the time of trauma, there was a significant peak during weekends (95 patients). One hundred forty-one of the fifth metacarpal fractures were caused by accidental trauma (99 males, 42 females). In this group, the fractures were located approximately equally in the subcapital, diaphyseal, and basal part of the metacarpal. The median age was 34 (2-90) years. The accidental traumas occurred about as often during the weekdays as during the weekend.

Of all hand fractures, fractures of the fifth metacarpal bone are the most common. There are as many aggression-related fractures as accidental fractures in the fifth metacarpal bone. When the fracture is caused by aggression, the typical patient is a young male sustaining fracture during the weekend.