The fifth metacarpal is the long bone of the palm on the little finger side. Its base articulates with the hamate and the fourth metacarpal, its head forms the knuckle of the little finger, and it gives attachment to extensor carpi ulnaris, opponens digiti minimi and the interossei.
| Articulations |
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| Landmarks |
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| Ossification | Ossifies from a primary centre in the shaft at about the ninth fetal week and a secondary centre in the head appearing at about 2-3 years, fusing at about 14-17 years. |
The fifth metacarpal neck is the most commonly fractured metacarpal site, typically after punching (boxer's fracture). A degree of angulation is tolerated because the fifth carpometacarpal joint is mobile, but rotational deformity causes the little finger to cross the ring finger and must be corrected. Fractures of the base can be associated with dislocation at the hamate.
A fracture of the fifth metacarpal neck from punching, producing a depressed knuckle and palmar angulation of the head.
An intra-articular fracture-dislocation of the fifth metacarpal base, where extensor carpi ulnaris pulls the shaft proximally and dorsally.
Spiral or transverse shaft fractures that may rotate the little finger and need correction to avoid scissoring.
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