Treatment of Oblique Fracture at Neck of Fourth Metacarpal

Initial Assessment

• Initial evaluation requires 3-view radiographs of the hand to confirm diagnosis and assess fracture characteristics, according to the American College of Radiology 1, 2
• Additional imaging with CT may be considered if radiographs are equivocal to better visualize fracture pattern, as recommended by the American College of Radiology 1

Treatment Algorithm

Potential Complications

• Rotational deformity causing finger overlap, a potential complication of oblique fractures at the neck of the fourth metacarpal, is a concern, as noted by the American College of Radiology 1

Post-Treatment Management

• Regular follow-up with serial radiographs to ensure proper healing and alignment is necessary, according to the American College of Radiology 1

Surgical Management

• Interfragmentary screws are appropriate for long oblique fractures, providing compression across the fracture site, as described by the American College of Radiology 1