Metacarpal fractures are most common in younger adults and adolescents.

Anatomy of the Metacarpal Bones of the Hand

The metacarpal bones are the long bones of the hand. They make up the palm area of the hand and run from the wrist bones to the first finger bones. There are five metacarpals, named the first to the fifth.

How The Metacarpals Are Fractured

Metacarpals are commonly fractured by what is called axial load, a force applied along the length of the bone from one end. Punching someone or something is a common reason for this fracture as is falling on the hand.

Metacarpal Fracture Symptoms

Immediate pain after the impact will signal that a severe injury has occurred and the hand will be difficult to move or use. Bruising may appear after some time has elapsed. Displaced fractures or dislocations are obvious because of the deformity of the hand.

Metacarpal Fracture Types

Around 10% of fractures are of the metacarpals and fingers, with around 30-40% of hand fractures involving the metacarpals. 10% of hand fractures involved the fifth metacarpal.

  • Injuries to the base of the first metacarpal. This is part of the thumb.
  • Fractures to the shaft and near ends of the metacarpals – the metacarpal necks (a common punching injury)
  • Injuries to the knuckles, the metacarpal heads
  • Dislocations of the finger joints from the knuckles of the metacarpals

Metacarpal Fracture Illustration

Bennett fracture is a fracture of the base of the first metacarpal that extends into its joint with one of the wrist bones. This is an intra-articular fracture that needs careful treatment if the function of the joint is to be restored to normal.

A boxer’s fracture typically involves the fourth and fifth metacarpals and results from hitting a solid object with a clenched fist.

Metacarpal Fracture Treatment

Most metacarpal fractures do not require operation. If the fracture is displaced then a patient is sedated while the fracture or dislocation is relocated. The arm is then splinted to maintain the alignment and stability of the fracture and allow wrist and finger movements to be practised.

Buddy taping of the fractured finger to those each side of it is a common treatment for un-displaced fractures and allows for gentle hand function while the fracture heals.

Physiotherapy for Metacarpal Fractures

Physiotherapy and occupational therapy teams working in specialist hand teams provide splinting and advice for metacarpal fractures as well as many other hand injuries and operations.

Physiotherapy is rarely needed for rehabilitation of metacarpal fractures as normal function of the hand typically returns it to normal function.


  1. General Information on Hand Fractures. BSSH.
  2. Metacarpal fractures. Kollitz, Kathleen M. et al. “Metacarpal Fractures: Treatment and Complications.”Hand (New York, N.Y.) 9.1 (2014): 16–23. PMC. Web. 9 Aug. 2016.

Last Review Date: 25-03-2018

Next Review Date: 25-03-2020