The Epidemiology of Metacarpal Fractures: A Descriptive Study Based on 18,802 Fractures From the Swedish Fracture Register.

Purpose: Hand fractures are common injuries, but there are few large and detailed epidemiological reports describing them. Methods: This study describes the distribution of metacarpal fractures and their impact on patient-reported outcome measures based on 18,802 fractures from the Swedish Fracture Register. Results: The mean age at the time of injury was 39 years (men 33 years and women 52 years). The age distribution for women was bimodal. For men, there was unimodal peaking in early adulthood. Male injuries represented 70% of all metacarpal fractures. In men and children, the most common fracture was a distal extra-articular fracture of the fifth metacarpal, whereas in women, it was a shaft fracture of the fifth metacarpal. Fracture localization differed between metacarpals; 79% of the fractures in the first metacarpal were proximal, compared with 19% to 25% in the other metacarpals. Shaft fractures were the most common in the third and fourth metacarpals, and distal fractures were the most common in the second and fifth metacarpals. The most common cause of injury was a fall. Fractures of the first metacarpal were treated surgically to a greater extent than fractures in the other metacarpals. Men were operated on more often than women (19% vs 14%). Metacarpal fractures did not affect patient-rated hand function or quality of life 1 year after injury. Conclusions: Metacarpal fractures are common and mostly treated nonsurgically and have a minimal effect on patient well-being. Type of study/level of evidence: Therapeutic II.