Jeremy Field - Consultant Orthopaedic and Hand Surgeon

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These tend to be either transverse oblique or sometimes spiral. They can be associated with rotation of the fingers and metacarpal fractures tend to displace volarly i.e. the end of the bone pointing to the palm) this is due to the fact that most injuries associated with metacarpals are usually associated with a clenched fist and there are some small muscles that cross the first knuckle on the volar or palmar side and these pull these fractures into flexion.

these X-rays show little finger metacarpal fracture

Stable fractures such as transverse fractures can be treated conservatively i.e. non-operatively. This means a local anesthetic regional block is given probably a wrist block with local anesthetic is given at this level, the fracture is then manipulated straight and held in a plaster of Paris in the position of function, or Edinburgh position(ref). Unstable fractures tend to be treated operatively