RT Book, Section A1 Breed, Meghan A1 Fitch, Robert Warne A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181041957 T1 Boxer’s Fracture T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181041957 RD 2024/03/28 AB A metacarpal neck fracture of the 5th digit may occur after a direct blow to the MCP joints of the clenched fist. The apex of the fractured metacarpal bone is dorsal. On physical examination, the “knuckle” is flattened and can be palpated on the volar surface. Exam should address neurovascular integrity and rotational deformity. Rotational deformity is evaluated by having the patient flex the digits at the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints; the four digits should point toward the scaphoid. If the involved digit overlaps another digit or does not point toward the scaphoid, a rotational deformity is present and needs to be corrected.