Diagnosis and treatment of a closed and inverted metacarpal head fracture
Abstract This case report documents a rare inversion of a closed metacarpal head fracture in the setting of polytrauma. Although rare, hemispherical articular bones can fracture and rotate 180°. Because of the symmetry of the bone and the rarity of an inverted, metacarpal head fracture, a delay in d...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-06-01
|
| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12428 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849401507281108992 |
|---|---|
| author | Jinghong Wesley Yuan Michael R. Boniello David A. Fuller |
| author_facet | Jinghong Wesley Yuan Michael R. Boniello David A. Fuller |
| author_sort | Jinghong Wesley Yuan |
| collection | DOAJ |
| description | Abstract This case report documents a rare inversion of a closed metacarpal head fracture in the setting of polytrauma. Although rare, hemispherical articular bones can fracture and rotate 180°. Because of the symmetry of the bone and the rarity of an inverted, metacarpal head fracture, a delay in diagnosis and subsequent treatment can occur, which can lead to a poor outcome. This is particularly true in the setting of polytrauma. A 38‐year‐old male, polytrauma patient presented to the emergency department (ED) after falling off a bridge and being struck by an oncoming vehicle. He presented with multiple surgical fractures of the upper and lower extremities as well as his pelvis. Three days after he was brought to the ED, x‐rays were performed of his painful left hand, which revealed an extra‐articular third metacarpal head fracture, for which he underwent open reduction of the closed fracture. Both collateral ligaments were intact and the head fragment had inverted within the constraints of these ligaments. Some of the ligament and capsular tissue remained attached to the head fragment along the radial and ulnar margins but was otherwise entirely covered with cartilage. The reduction maneuver was difficult but after the reduction was achieved, the fracture appeared stable and no internal fixation was used. Post reduction, the injury was splinted for 2 weeks and then early motion was allowed. The fracture has since healed, and the patient has attained near‐full function of the finger and joint. |
| format | Article |
| id | doaj-art-8d367958a5404f018de53f5fcc3be81a |
| institution | Kabale University |
| issn | 2688-1152 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-8d367958a5404f018de53f5fcc3be81a2025-08-20T03:37:45ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522021-06-0123n/an/a10.1002/emp2.12428Diagnosis and treatment of a closed and inverted metacarpal head fractureJinghong Wesley Yuan0Michael R. Boniello1David A. Fuller2Cooper Medical School of Rowan University Camden New Jersey USADepartment of Orthopaedic Surgery Cooper University Hospital Camden New Jersey USADepartment of Orthopaedic Surgery Cooper University Hospital Camden New Jersey USAAbstract This case report documents a rare inversion of a closed metacarpal head fracture in the setting of polytrauma. Although rare, hemispherical articular bones can fracture and rotate 180°. Because of the symmetry of the bone and the rarity of an inverted, metacarpal head fracture, a delay in diagnosis and subsequent treatment can occur, which can lead to a poor outcome. This is particularly true in the setting of polytrauma. A 38‐year‐old male, polytrauma patient presented to the emergency department (ED) after falling off a bridge and being struck by an oncoming vehicle. He presented with multiple surgical fractures of the upper and lower extremities as well as his pelvis. Three days after he was brought to the ED, x‐rays were performed of his painful left hand, which revealed an extra‐articular third metacarpal head fracture, for which he underwent open reduction of the closed fracture. Both collateral ligaments were intact and the head fragment had inverted within the constraints of these ligaments. Some of the ligament and capsular tissue remained attached to the head fragment along the radial and ulnar margins but was otherwise entirely covered with cartilage. The reduction maneuver was difficult but after the reduction was achieved, the fracture appeared stable and no internal fixation was used. Post reduction, the injury was splinted for 2 weeks and then early motion was allowed. The fracture has since healed, and the patient has attained near‐full function of the finger and joint.https://doi.org/10.1002/emp2.12428avascular necrosis of the metacarpal boneflipped metacarpal head fractureinverted, metacarpal head fracturemetacarpal head fractureopen reductionpolytrauma |
| spellingShingle | Jinghong Wesley Yuan Michael R. Boniello David A. Fuller Diagnosis and treatment of a closed and inverted metacarpal head fracture Journal of the American College of Emergency Physicians Open avascular necrosis of the metacarpal bone flipped metacarpal head fracture inverted, metacarpal head fracture metacarpal head fracture open reduction polytrauma |
| title | Diagnosis and treatment of a closed and inverted metacarpal head fracture |
| title_full | Diagnosis and treatment of a closed and inverted metacarpal head fracture |
| title_fullStr | Diagnosis and treatment of a closed and inverted metacarpal head fracture |
| title_full_unstemmed | Diagnosis and treatment of a closed and inverted metacarpal head fracture |
| title_short | Diagnosis and treatment of a closed and inverted metacarpal head fracture |
| title_sort | diagnosis and treatment of a closed and inverted metacarpal head fracture |
| topic | avascular necrosis of the metacarpal bone flipped metacarpal head fracture inverted, metacarpal head fracture metacarpal head fracture open reduction polytrauma |
| url | https://doi.org/10.1002/emp2.12428 |
| work_keys_str_mv | AT jinghongwesleyyuan diagnosisandtreatmentofaclosedandinvertedmetacarpalheadfracture AT michaelrboniello diagnosisandtreatmentofaclosedandinvertedmetacarpalheadfracture AT davidafuller diagnosisandtreatmentofaclosedandinvertedmetacarpalheadfracture |