5th Metacarpal Neck Fractures

Patient Experience

  • Reference Number: HEY-1335/2022
  • Departments: Plastic Surgery
  • Last Updated: 3 January 2022


This advice sheet has been produced to give you information about your condition. It is not meant to replace discussion between you and the healthcare team.  If after reading it, you require further explanation please discuss this with a member of the healthcare team. This is a common injury often as a consequence of a punching injury. The fracture (break in the bone) is located just before the knuckle joint of the little finger.

Expected functional and cosmetic results

The fracture usually heals well with normal movements and grip strength. You may expect some loss of prominence of the 5th knuckle and a visible lump at the fracture site just before the knuckle. This lump represents the bone healing process and tends to decrease over several months.

Pain and swelling

The fracture site may be painful and swollen for the first week or so. Resting the hand, keeping it elevated and avoiding letting it hang down by your side will help the swelling to go down which will also help reduce pain and discomfort. Taking over the counter pain relief medication such as paracetamol and ibuprofen (if these are suitable for you) should also be helpful. Some pain may persist for 4 – 6 weeks and occasionally longer.


It is important that during the course of healing and recovery you should keep moving your fingers. Try to close them to make a fist and then open them fully within pain limits. Continuing to do this will help improve your hand and finger activity. The fracture normally heals in 4 – 6 weeks by which time you should be able to do the majority of the activities you were doing before the injury. Some patients find they recover more quickly whilst others may feel they are progressing more slowly. This is normal. Formal physiotherapy is not usually needed but if you feel you are struggling, please contact the Plastics Trauma Clinic for advice on (01482) 674509.

Return to work / sports

This depends a lot on the kind of job you do and work can usually be resumed as soon as comfortable. You will not damage your hand or stop the fracture healing by using it. It is advisable not to drive for the first few days or week or so until the pain has settled and you can control the car and perform an emergency stop. Some people with heavy manual work or who drive as part of their job may need a couple of weeks off work. The fracture remains vulnerable to further impact over the first few weeks so caution should be applied for this time before returning to contact sports.

Reasons for concern

Aches, pains and weakness of grip usually continue for several weeks but gradually improve. If your hand remains very stiff or painful, you should contact the Plastics Trauma Clinic on (01482) 674509 or your doctor for advice.

Should you require further advice on the issues contained in this advice sheet, please do not hesitate to contact the Plastics Trauma Clinic (01482) 674509.

This leaflet was produced by the Department of Plastic Surgery and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust and will be reviewed in January 2024

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

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The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
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  • you must be acting under your own free will and not under the strong influence of another person

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