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.
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.
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