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Right Hand Pain
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Right Hand Pain - February 13, 2005 9:33:00 PM
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Alex Brenner PT MPT OCS
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From: Kentucky
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We'll go without a history for now.
(All images obtained and used with permission)
[IMG]http://img.photobucket.com/albums/v85/brennerak/hand1.jpg[/IMG]
[IMG]http://img.photobucket.com/albums/v85/brennerak/Hand2.jpg[/IMG]
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Alex Brenner, PT, MPT, OCS
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Re: Right Hand Pain - February 14, 2005 2:01:00 AM
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SJBird55
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Distal end of the 5th metacarpal has some kind of issue going on.
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Re: Right Hand Pain - February 14, 2005 2:14:00 AM
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Jon Newman
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Maybe a boxer's fracture?
jon
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Re: Right Hand Pain - February 14, 2005 3:09:00 AM
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ehanso
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There appears to be a diagonal fracture just proximal to the head of the 5th metacarpal.
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Re: Right Hand Pain - February 14, 2005 3:38:00 AM
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newcastle
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I am in agreement with both FallsPT and jon who think it is a fracture(could be an oblique one)of the distal end 5th metacarpal from some of trauma e.g. boxer's.
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Re: Right Hand Pain - February 14, 2005 4:07:00 AM
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jma
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Fx of just dital proximal 5th MTP. Boxer's Fx
JMA
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Re: Right Hand Pain - February 14, 2005 4:14:00 AM
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JLS_PT_OCS
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Yes, boxer's fx of 5th metacarpal.
Seems displaced, should be referred to Ortho right away.
One of the leading cases of medical malpractice in Orthopedic medicine - rotational deformity of metacarpal after casting for fx.
The Orthopod needs to determine whether to percutaneously pin it or cast it.
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Right Hand Pain - February 14, 2005 4:43:00 AM
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steve
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What did he hit? Always a good story!
Steve
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Re: Right Hand Pain - February 14, 2005 8:20:00 AM
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Synergy
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From: Texas
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I agree with the above, but what is that horizontal line in the middle of the 1st metacarpal?
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Chris Adams, PT, MPT
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Re: Right Hand Pain - February 14, 2005 10:08:00 AM
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jma
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Yes, I too see a horizontal line. Perhaps it could have been a stress fx at one point. It is nondisplaced.
JMA
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Re: Right Hand Pain - February 21, 2005 10:56:00 PM
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Alex Brenner PT MPT OCS
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There is a nondisplaced fracture of 5th Metacarpal.
This fracture is sometimes referred to as a "boxers" fracture or probably better referred to as a "street fighters" fracture. Supposedly trained boxers do not use the ulnar portion of the hand to box but instead try to strike their opponent with the 2nd and 3rd metatarsals where the force can be transmitted down the hand and along the radius resulting in a stronger punch. Untrained boxers or intoxicated army soldiers will commonly punch walls, wall lockers, metal poles and each other resulting in the below fracture.
(All images obtained and used with permission)
[IMG]http://img.photobucket.com/albums/v85/brennerak/hand3.jpg[/IMG]
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Alex Brenner, PT, MPT, OCS
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Re: Right Hand Pain - February 21, 2005 10:56:00 PM
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Alex Brenner PT MPT OCS
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The horizontal line through the first metacarpal is normal.
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Alex Brenner, PT, MPT, OCS
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Re: Right Hand Pain - February 22, 2005 4:15:00 AM
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jma
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Thanks for the clarification about the horizontal line. When I see something like that, what jumps to mind is an old stress fracture, instead of a normal anatomic image.
JMA
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Re: Right Hand Pain - February 22, 2005 4:26:00 AM
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Alex Brenner PT MPT OCS
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Hi JMA. In my experience, healing stress fractures have a fairly large callous formation around the bone (like the image below) that can be observed even a year after the injury.
I personally have never seen a stress fracture in hand; I think they exist but are not very common.
[IMG]http://img.photobucket.com/albums/v85/brennerak/stressfxhealed.jpg[/IMG]
The line that was observed in the first metacarpal has a name but I can not remember what it is called. I will try and look it up. They are also commonly seen in the lower extremities.
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Alex Brenner, PT, MPT, OCS
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Re: Right Hand Pain - February 22, 2005 6:45:00 AM
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Yogi
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Yeah, if you ever feel the need to punch a door for a stress reliever, make sure it's a hollow core.
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Re: Right Hand Pain - February 22, 2005 8:16:00 AM
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Synergy
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From: Texas
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Army,
The line we're referring to...is it called "the dreaded black line"?
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Chris Adams, PT, MPT
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Re: Right Hand Pain - February 22, 2005 9:25:00 AM
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UTDC
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Hey Chris,
I believe that "dreaded black line" refers to the plain film finding seen with anterior tibial stress fracture.
Jeff
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Re: Right Hand Pain - February 22, 2005 2:45:00 PM
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Synergy
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From: Texas
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Thanks for the correction Jeff! I knew I heard that somewhere, but wasn't quite sure what it pertained to. :)
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