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significantly angulated or displaced fractures can often be predicted based on
examination. Most nondisplaced shaft fractures can be managed with
immobilization, though fractures with significant displacement may require
operative stabilization.

FIGURE 109.13 Anteroposterior radiograph of the hand depicting a displaced fifth metacarpal
neck fracture. (Courtesy of Children’s Orthopaedic Surgery Foundation.)

Fractures of the metacarpals are least likely to occur in the base of the bone.
When these occur, they usually involve the small finger. There will be significant
pain and dorsal edema, which can make accurate diagnosis challenging. Plain