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Updated: May 6, 2026

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Published on: April 5, 2024
Occult Compression Fracture of Metacarpal Head without Evidence of Avascular Necrosis
Keiichiro Nishida1, Hiroyuki Hashizume, Akihiro Matsukawa
1Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.knishida@md.okayama-u.ac.jp.
Abstract:
We report a case of 4th metacarpal head collapse of a 19-year-old healthy man. MRI revealed T1 low and T2 high regions in the collapsed 4th metacarpal head, as well as in the right 3rd and left 4th metacarpal head. Our initial diagnosis was occult compression fracture due to avascular necrosis, known as Dieterich's disease. However, pathological findings of surgically resected right 4th metacarpal head were compatible with transient osteoporosis and metacarpal head fracture followed by active tissue repair. The autologous osteochondral transplants from costchondral junction survived and maintained their size and shape even at 10-year follow-up.
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