Abstract
Intra-articular metacarpal head fracture is relatively rare. We report a case of coronal
intra-articular and epiphyseal fractures of Salter–Harris type IV injury in the metacarpal
head of the index finger. Surgery was performed by a dorsal approach. The volar fragment
that was displaced proximally was gently reduced while bending the metacarpophalangeal
(MP) joint, and it was fixed with cortical screws inserted proximal to the articular
cartilage facilitating early rehabilitation. We consider the mechanism of injury to
be a force applied from the distal phalanx that was transmitted unevenly to the volar
side when the MP joint was slightly flexed. A three-dimensional computed tomography
scan was useful in making the precise diagnosis, confirming the fracture pattern and
planning fixation of the fracture.
Keywords
coronal fracture - epiphyseal fracture - metacarpal head - adolescence
