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Fractures of the Palm

(Metacarpal Fractures)

By Danielle Campagne, MD , Department of Emergency Medicine, University of San Francisco - Fresno

Fractures of the palm involve the bones located between the finger bones and wrist bones (metacarpal bones). Occasionally, the metacarpal bone at the base of the thumb fractures, but these fractures are usually considered separately.

The metacarpal bones may be broken near the joint between the fingers and the palm (called metacarpal neck fractures). Metacarpal neck fractures are common. Often, they are called boxer's fractures because they result from punching a hard object (such as a wall or another person's jaw). When these fractures result from punching someone in the mouth, the skin may be broken. In such cases, bacteria from the other person's mouth can contaminate the wound and cause infections that, if not treated soon, can permanently affect use of the hand.

Symptoms

The knuckles become swollen and tender. Occasionally, the broken pieces of bone are out of place (misaligned) or rotate so that a finger is out of position.

Diagnosis

  • X-rays

If people think that they may have fractured their palm, they should see a doctor. Usually, doctors can diagnose the fracture based on x-rays taken from several angles.

Treatment

  • Realignment of the broken bones

  • A splint

  • Range-of-motion exercises

If people have wounds near the injured joint, they may have punched someone in the mouth. If they did punch someone in the mouth, doctors may clean out the wound and give them antibiotics to prevent infection.

If the broken pieces are badly misaligned or rotated, doctors move them back in place without surgery—called closed reduction. Then, a splint is applied and worn for several weeks.

Exercises to move the hand and fingers through their full range of motion are started gradually. Typically, people regain full use of their hand.

* This is the Consumer Version. *