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Fifth metacarpal neck fracture — RCPSC EM MCQ

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ModerateMusculoskeletalFifth metacarpal neck fractureRCPSC EM

A 27-year-old man punches a wall and presents with ulnar hand pain. There is swelling over the fifth metacarpal neck, rotational deformity when he flexes the fingers, and normal sensation. X-ray shows an angulated fifth metacarpal neck fracture. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Boxer's fracture with clinically significant rotation

A fifth metacarpal neck fracture after punching with rotational deformity is a boxer's fracture that usually needs reduction or hand-surgery follow-up.

Reference: Royal College Emergency Medicine exam format and training experiences