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Date issued: December 2022

Review date: December 2024

Ref: A-530/NB/ED/Fifth (Little) Metacarpal Fracture

PDF:  Fifth (Little) Metacarpal Fracture final December 2022.pdf [pdf] 110KB

What has happened to my hand?

• You have broken the end of a bone in your hand near the knuckle. 

• The little and ring fingers have been taped together to support the bones but allow some early movement at the knuckle.

What should I do now?

• No further treatment is necessary in most cases.

• Keep the little and ring fingers taped together for 3 weeks (the tapes can be taken off in order to wash and fresh tape can be reapplied).  Discard the tapes after 3 weeks.

• Gentle movement is a good thing even if it is a bit uncomfortable initially.  This prevents the knuckle from becoming stiff and encourages swelling to settle. 

• You can gently start to use the hand for light activities but if your work involves very repetitive or strenuous use of the hand then you may need to alter what you do or take time off work.

• You can take part in contact sports after 3 weeks but try to tape the fingers together during sports for a further 3 weeks.

• Take pain-relief (paracetamol and/or ibuprofen) for the first 2 weeks after injury.

• By the end of 3 weeks much of the movement range should have returned and you can exercise and stretch the knuckle a bit in order to improve the movement range, squeezing a ball of Plasticine or poster putty is a helpful exercise.

What recovery can I expect?

• In almost all cases these injuries heal very well although the knuckle may heal in a pushed-down position.  This does not affect the function of the hand.

• You can expect to reach nearly full range of motion once the bone has completely healed. 

• Most of the swelling and pain should settle over the course of 3 weeks but can sometimes take up to a year to fully settle. 

• There may be a hard lump where the break is for approximately a year: This is new bone which forms in order to mend the break and smooths out as the bone strengthens. 

What problems can occur?

• Very occasionally after injuries to the hand there can be swelling and pain which is prolonged and can lead to long term difficulties.  Ordinarily, swelling and pain will worsen for a few days after injury and then start to improve.

If swelling / pain continues to worsen a week after injury or if you cannot touch your fingers to the palm of the hand after 3 weeks, you should contact the hand surgery department (0845 1558155 and ask for bleep 0169; 9am-3pm weekdays).

• Sometimes the little finger seems to droop down a little bit or it rests slightly apart from the other fingers.  This typically corrects itself.  If this problem is still apparent after 3 months, you should ask your GP to refer you back to the plastic surgery department.