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In a Boxer's Fracture, the injury is most commonly seen at the fourth metacarpal, the "ring" finger, and the fifth metacarpal, the "pinky" finger.

 

Bony Structures

The hand is composed of:

  • 14 phalanx bones

  • 5 metacarpals

  • 8 metacarpals

    • First row (proximal) from medial to lateral

      • Scaphoid

      • Lunate

      • Triquetrum

      • Pisiform

    • Second row (distal) from medial to lateral

      • Trapezium

      • Trapezoid

      • Capitate 

      • Hamate

 

Metacarpals are classified as long bones. They each have a base, shaft, neck, and head.

  • The base of the fourth metacarpal articulates with both the hamate and capitate and the third and fifth metacarpals on the ulnar and radial side respectively.

  • The base of the fifth metacarpal articulates with the hamate and the base of the fourth on the ulnar side.

 

Muscular Attachment

Then hand is capable of

  • Flexion, extension, abduction, and adduction of the fingers and thumb

  • Opposition and circumduction of the thumb

  • Flexion, extension, radial deviation, and ulnar deviation of the wrist

 

Both serve at important attachment sites for muscles of the hand. 

  1. The fifth metacarpal serves as the attachment site for extensor carpi ulnaris, the fourth interosseous dorsalis, and little finger extensor tendons. 

  2. The fourth metacarpal serves as the origin of the third interossei which assist the lumbricles in adduction and abduction of the digits.

Vasculature

Blood supply to the hand comes from the radial and ulnar arteries and travels to the phalanges via the common digital arteries.

 

Blood then leaves the phalanges from the dorsal digital veins and moves through the radial vein and the posterior ulnar vein towards the the cephalic and antebrachial veins.

Click images below to enlarge

Anatomy

Hand and Wrist

Created by Shannon Flynn & Jordan Devenney

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