The five metacarpals are the bones of the palm connecting the carpal bones to the proximal phalanges, numbered 1 (thumb) to 5 (little finger). The first metacarpal is the shortest and most mobile, while the second and third are firmly fixed.
| Articulations |
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| Landmarks |
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| Ossification | First metacarpal ossifies like a phalanx with a proximal epiphysis. Metacarpals 2 through 5 have distal epiphyses appearing between ages 2 and 3. |
The five metacarpals form the framework of the hand dorsum, numbered 1 (thumb) to 5 (little finger). Metacarpal fractures are among the most common hand fractures. Boxer fractures of the fifth metacarpal neck from punching produce a characteristic volar angulation that is acceptable up to 40 to 45 degrees. Bennett and Rolando fractures of the first metacarpal base are intra-articular fractures requiring surgical reduction. Metacarpal shaft fractures from direct blows produce rotational deformity that must be corrected to prevent finger scissoring.
A fracture of the fifth metacarpal neck from punching a hard object, producing a depressed knuckle; rotational deformity must be checked.
An intra-articular fracture-dislocation at the base of the first metacarpal, where the abductor pollicis longus pulls the shaft away from a small volar fragment.
Shaft fractures can cause finger rotation (scissoring) if malaligned and are treated with splinting or fixation.
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