Fifth metacarpal neck fracture, usually secondary to a direct blow or closed-fist impact.
Potentially an unstable fracture and difficult to maintain reduction due to tension from tendons and muscles in the hand.
Up to forty degrees of angulation can be tolerated without repair, although there is potential for reduced hand function without repair. Any rotational deformity, however, must be corrected.
Non-displaced fractures: RICE therapy, gutter splint, and Ortho follow-up.
Displaced, rotated, or angulated fractures (>40 degrees): closed reduction may be attempted but surgical fixation usually required.
References
Many thanks to Dr. George Kochman for submitting this case!
