The shaft of each metacarpal widens at its distal end to form a neck and finally the metacarpal head. The body or shaft of each metacarpal is curved and this gives the palm of the hand its characteristic cup shape. Each metacarpal has a base that articulates with the distal row of carpal bones. The metacarpal bones are numbered one to five, with one corresponding to the thumb and five the little finger. The main body of the hand is formed by the five metacarpal bones, and is commonly referred to as the palm. Fractures to carpal bones are relatively uncommon and will not be discussed. They are arranged into two separate rows, with the proximal row forming part of the wrist joint and the distal row articulating with the base of the metacarpal bones in the palm of the hand. The carpal bones form the base of the hand and the wrist joint, there are eight in total which are small and irregularly shaped. These terms are important when describing fractures and how they are displaced, subluxed or angulated. The two lateral borders of the hand are commonly referred to according to their relation with the bones of the forearm, with the thumb forming the radial border and the little finger relating to the ulnar border. The hand has a volar surface that includes the palm, and a dorsal surface that is commonly referred to as the “back” of the hand. There are twenty-seven bones within the hand, arranged into three distinct groups - carpals, metacarpals and phalanges. Each hand is attached to the forearm at the wrist joint. The hand consists of a main body known as the palm and five digits - a thumb and four fingers. Despite this being the case, this paper intends to deal mainly with the bone injury and aims to discuss both the timing, as well as the methods available, of hand fracture management. These decisions are dependant on a wide range of factors including age, hand dominance, occupation and co-morbidities.Ī fracture is best described as a soft tissue injury with an associated bony injury. Appropriate evaluation at first presentation, as well as during their management, can significantly prevent both morbidity and disability to a patient. Hand fractures are the most common fractures presenting at both accident and emergency and within orthopaedic clinics. Allowing the ability to grasp, and differentiated from other animals by an opposing thumb, the main functions include both fine and gross motor skills as well as being a key tool for sensing and understanding the immediate surroundings of their owner. The hand is essential in humans for physical manipulation of their surrounding environment.
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