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Case Reports
. 2022 Jan 15;4(4):249-253.
doi: 10.1016/j.jhsg.2021.11.005. eCollection 2022 Jul.

Fracture of the Volar Ulnar Index Metacarpal Base: Literature Review

Kelly N McKnight  1 , Robert E Van Demark Jr  2 , Vanessa J S Smith  2 , Meredith Hayes  3
Affiliations
Case Reports

Fracture of the Volar Ulnar Index Metacarpal Base: Literature Review

Kelly N McKnight et al. J Hand Surg Glob Online. .

Abstract

Information regarding the management of intra-articular base fractures of the index metacarpal is scarce. Fractures of the base of the index metacarpal are rare because of the inherent stability of the joint. Of the handful of case reports on this injury, there appear to be 2 main patterns: fractures of the dorsal radial condyle and fractures of the volar ulnar condyle, which are attached to the extensor carpi radialis longus and flexor carpi radialis tendons, respectively. Although majority of previously reported volar fragment fractures were treated with Kirschner wire stabilization, we reported a case that was managed nonsurgically. The case presented is of a 70-year-old man with a fracture of the volar ulnar condyle of the base of the index metacarpal. Although he initially struggled with swelling of the hand and mobility of the fingers, he did well with nonsurgical management and regained full strength in his hand.

Keywords: CMC joint fracture; Fracture; Metacarpal fracture.

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Figures

Figure 1
Figure 1
Plain x-ray images. Posteroanterior, oblique, and lateral radiographs of the left hand demonstrate a fracture of the volar base of the second metacarpal (white arrow).
Figure 2
Figure 2
Computed tomography scan of the left hand. A coronal computed tomography image of the hand demonstrates an impacted fracture of the second metacarpal base. A sagittal computed tomography image demonstrates a displaced fracture of the second metacarpal base, with volar displacement (white arrow).
Figure 3
Figure 3
Three-dimensional computed tomography scan image. Three-dimensional reconstruction demonstrates a displaced intra-articular second metacarpal base fracture (white arrow).
Figure 4
Figure 4
Initial clinical photographs of the left hand.
Figure 5
Figure 5
Clinical photographs 6 months after the injury.
Figure 6
Figure 6
Posteroanterior and lateral radiographs of the left hand 6 months after the injury demonstrate the second metacarpal base volar fracture fragment (white arrow).
Figure 7
Figure 7
Plastic hand model. The dorsal and volar views demonstrate the bony anatomy of the second carpometacarpal joint (white circle).
Figure 8
Figure 8
Plastic hand model. The volar aspect of the carpus demonstrates the flexor carpi radialis tendon’s dual insertion into the base of the second metacarpal (black arrow) and the base of the third metacarpal (white arrow).
Figure 9
Figure 9
Plastic hand model. A dorsal view of the carpus demonstrates the ECRL tendon on the radial condyle of the second metacarpal base (white arrow).
See this image and copyright information in PMC

References

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