Quick Tips: Named Fractures – Part One: Hand & Forearms

This blog post is the 3rd in its series on bone fractures. To view the first blog post on the basic fracture types and information, including open and closed fractures, click here.

This blog post will highlight some of the common ‘named’ fractures you will often find in archaeological and anthropological settings. It is important to know their characteristics and common causes to help establish what happened – whether the fracture was received by defensive or offensive action, or purely accidental. This blog post will examine the first five common fractures associated with the hand and forearm bones.

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Common ‘Named’ Fractures of the forearms and hands: A) Boxer’s fracture, B) Bennett’s fractures, C) Parry’s or Monteggia’s fracture, D) Colles’ fractures, and E) Smith’s fractures.

The first two fractures we will look at affect the metacarpal bones;

A)     Boxer’s fracture: This fracture occurs due to the axial loading, meaning a force was applied along/parallel to the axis of the bone, on the transverse neck of the 4th and 5th metacarpal, secondary to an indirect force. A Boxer’s fracture often happens due to punching an object/person with a closed fist, hence the name ‘Boxer’ being associated to it.

B)      Bennett’s fracture: This fracture affects the 1st metacarpal (thumb) and extends into the carpometacarpal (CMC) joint which is complicated by subluxation (dislocation of a joint). A Bennett’s fracture is an oblique (See 1st blog post for meaning, click here) intra-articular metacarpal fracture caused by an axial force directed against the partially flexed metacarpal. This injury is also common when someone punches a hard object, but its most common cause is falling onto the thumb. An example of this is falling off a bike, as the thumb is extended around the handle bars.

The last three fractures affect the longbones of the forearm, the ulna and radius;

C)      Parry’s/Monteggia’s fracture: This fracture occurs on the proximal third of the ulna with subluxation of the radius/ulna. The most common cause of this fracture is by blunt force trauma caused by lifting the forearm up to protect the head or body in defence from an oncoming attack/striking object.

These two fractures affect the distal radius but cause displacement in two directions;

D)     Colles’ fracture: A Colles’ fracture, also known as a “dinner fork” or “bayonet” fracture, occurs when the distal radius is broken with dorsal displacement of the wrist and hand. This fracture is common when the person falls forwards and uses their outstretched hand to cushion the fall, which causes the force to displace and break the head of the radius.

E)      Smith’s fracture: A Smith’s fracture is the same as the Colles’ fracture but with ventral displacement of the broken radius head. The cause of a Smith’s fracture is the same as the Colles’ fracture, but it is less common.

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Fractures: D) Colles’ fracture, and E) Smith’s fracture.

The next Quick Tips post will discuss other ‘named fractures’ in archaeological/anthropological situations and their causes and characteristics.

This is the third post of a set on fractures, so keep your eyes open for the other posts, and the new ones to come. To view all the other Quick Tips posts click here!

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