Neck of 5th metacarpal fracture A&E leaflet

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What is a neck of 5th metacarpal fracture?

You have an injury to the neck of your 5th metacarpal (long bone on the outside of your hand).

Healing

This normally takes approximately 4 to 6 weeks to heal. The knuckle on the outside of your hand is likely to always look different after this injury. This will not affect how you can do things.

Pain and swelling

Take your normal painkillers if it is painful. You may find it continues to be a bit achy and swollen for a few months after your injury. The splint / finger strapping provided is for comfort, it does not affect how well it heals. If your hand is swollen, keep your hand high up on your chest (using a sling) for the first couple of days.

Using your hand

You may use the hand. Work within your pain limits. It is important to keep the fingers bending to stop them becoming stiff. Avoid putting too much weight through your hand for the first 4 weeks.

Stop smoking

Medical evidence suggests that smoking increases the time it takes for a fracture to heal. In extreme cases it can stop healing altogether. Stopping smoking during the healing phase (6 weeks) of your fracture will help ensure the best recovery.

For advice on smoking cessation and local support available, please refer to NHS Quit Smoking or discuss this with your GP.

Follow up

We do not routinely follow up these injuries as they heal well. However, if you continue to have pain or are limited in what you can do please get in contact with us (number and email below).

Cold packs

A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. Put this on the sore area for up to 15 minutes, every few hours. Make sure the ice is never in direct contact with the skin.

What can I do to help my hand?

Stage 1 Exercises:

Gently move your fingers regularly throughout the day.

Stage 2 Exercises: after 3 weeks.

Squeeze a soft ball, playdough, plastic bottle or similar item in your hand. Do this for 30 to 60 seconds.

Practice your pinch grip; squeeze objects such as clothes pegs.

Practice hand movements: Here are some examples; turning keys, picking up small objects, doing crafts or anything that involves using your hands.

Frequently asked questions:

Is it a break or a fracture?

Both, these two words mean the same thing. There is no difference between a break and a fracture.

Help! My little finger won’t straighten!

This is common while the hand is still swollen. This movement should come back within the first 10 days. If it does not please contact us.

When can I drive?

When you are safe to do all emergency procedures with no hesitation. If you have a splint you should not wear this when driving.

When can I return to work and sport?

It depends on your job or sport. You should reduce the amount of lifting and loading for the first 4 to 6 weeks.

Where do I get a fit note (sick note) if I cannot work?

From A&E or your GP.