Amirthalingam S, Sameer M, Harshavardhan JKG. A Wrong Punch and a Rare Fracture! - A Case Report of Isolated Fourth and Fifth Metacarpal Base Fracture.
J Orthop Case Rep 2022;
12:110-113. [PMID:
37013244 PMCID:
PMC10066685 DOI:
10.13107/jocr.2022.v12.i11.3436]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/26/2022] [Indexed: 02/12/2023] Open
Abstract
Introduction
Isolated displaced fourth and fifth metacarpal base fracture without a carpometacarpal joint subluxation or carpal bone fracture by a punch injury is extremely rare. The site of the fracture in the metacarpal is determined by the type and direction of punch. These fractures usually occur as a result of misdirected blow or wrong punch on a hard surface with a clenched fist. To best of our knowledge, there are only few published case reports. The difficulties in management and biomechanics of such fractures with 10 months follow-up are discussed in this case report.
Case Report
A 37-year-old male right hand dominant person presented with pain and swelling of the right hand after punching a wall. The difficulties in reduction and fixation of such fracture, the functional and radiological outcome of minimally open Kirschner wires fixation of this type of fracture with 10-month follow-up and the fracture biomechanics has been discussed in this case report.
Conclusion
Clenched fist injury not always means a boxer fracture. This kind of rare fracture is also a possibility and should kept as a differential diagnosis. These fractures are easily misinterpreted by a beginner. Meticulous reduction techniques and fixation will yield better results.
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