Ring and Little Finger Metacarpal Fractures: Mechanisms, Locations, and Radiographic Parameters.
Summary of "Ring and Little Finger Metacarpal Fractures: Mechanisms, Locations, and Radiographic Parameters."
PURPOSE:
To describe a series of ring and little finger metacarpal fractures with regard to mechanism, location, midshaft diameter, and isthmus diameter, to better define injury patterns and assist the surgeon in selection of appropriately sized implants.
METHODS:
We reviewed all metacarpal fractures in skeletally mature patients who presented to a single surgeon over a 2-year period. Fractures of the ring and little finger metacarpals were analyzed with regard to mechanism and fracture location. Metacarpal midshaft and minimum isthmus diameters were measured on posteroanterior radiographs.
RESULTS:
A total of 101 fractures involved the ring and little finger metacarpals. Punching-type injuries accounted for most fractures in the little finger metacarpal (49 of 67) and ring finger metacarpal (26 of 34). Among these punching-related ring and little finger metacarpal fractures, the most common fracture location was the little finger metacarpal neck (34 of 75), followed by the ring finger metacarpal shaft (21 of 75). Among men in this series, the metacarpal midshaft and minimum isthmus diameters were significantly narrower in the ring finger metacarpal than in the little finger (7.4 vs 8.7 mm, p < .001; and 2.2 vs 3.8 mm, p < .001).
CONCLUSIONS:
Whereas punching injuries tended to cause neck fractures in little finger metacarpals in this series, they caused shaft fractures in ring finger metacarpals, which may thus be considered a variant boxer's fracture. Furthermore, in men with fractures, the ring finger metacarpal is significantly narrower than the little finger, both in midshaft diameter and isthmus diameter, which surgeons should consider when planning internal fixation. TYPE OF STUDY/LEVEL OF
EVIDENCE:
Prognostic IV.
Affiliation
Department of Orthopaedic Surgery, Lahey Clinic, Burlington, MA; and the Department of Orthopaedic Surgery, Brown University, Providence, RI.
Journal Details
This article was published in the following journal.
Name: The Journal of hand surgery
ISSN: 1531-6564
Pages: 1256-1259
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20684925
- DOI: http://dx.doi.org/10.1016/j.jhsa.2010.05.013
Medical and Biotech [MESH] Definitions
Skull Fractures
Fractures of the skull which may result from penetrating or nonpenetrating head injuries or rarely BONE DISEASES (see also FRACTURES, SPONTANEOUS). Skull fractures may be classified by location (e.g., SKULL FRACTURE, BASILAR), radiographic appearance (e.g., linear), or based upon cranial integrity (e.g., SKULL FRACTURE, DEPRESSED).
Trigger Finger Disorder
A painful disability in the hand affecting the finger or thumb. It is caused by mechanical impingement of the digital flexor tendons as they pass through a narrowed retinacular pulley at the level of the metacarpal head. Thickening of the sheath and fibrocartilaginous metaplasia can occur, and nodules can form. (From Green's Operative Hand Surgery, 5th ed, p2137-58).
Ring Finger Domains
A zinc-binding domain defined by the sequence Cysteine-X2-Cysteine-X(9-39)-Cysteine-X(l-3)-His-X(2-3)-Cysteine-X2-Cysteine -X(4-48)-Cysteine-X2-Cysteine, where X is any amino acid. The RING finger motif binds two atoms of zinc, with each zinc atom ligated tetrahedrally by either four cysteines or three cysteines and a histidine. The motif also forms into a unitary structure with a central cross-brace region and is found in many proteins that are involved in protein-protein interactions. The acronym RING stands for Really Interesting New Gene.
Ulnar Neuropathies
Disease involving the ULNAR NERVE from its origin in the BRACHIAL PLEXUS to its termination in the hand. Clinical manifestations may include PARESIS or PARALYSIS of wrist flexion, finger flexion, thumb adduction, finger abduction, and finger adduction. Sensation over the medial palm, fifth finger, and ulnar aspect of the ring finger may also be impaired. Common sites of injury include the AXILLA, cubital tunnel at the ELBOW, and Guyon's canal at the wrist. (From Joynt, Clinical Neurology, 1995, Ch51 pp43-5)
Hand Bones
The CARPAL BONES; METACARPAL BONES; and FINGER PHALANGES. In each hand there are eight carpal bones, five metacarpal bones, and 14 phalanges.
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