Isolated Spiral Fracture of the Right Fourth Metacarpal: "Power Drill Kickback Fracture"-A Distinct Fracture Pattern Caused by a Specific Mechanism of Injury.

Abstract

Background: Isolated spiral fractures of the metacarpals are relatively common injuries. However, we observed a distinct and consistent fracture pattern associated with a specific occupational mechanism of injury, which, to our knowledge, has not been previously reported in the literature.

Methods: We retrospectively reviewed the charts of 43 construction workers who presented with metacarpal fractures following hand injuries sustained due to sudden drill kickback. This mechanism typically involved the drill bit becoming abruptly lodged in concrete, causing a forceful rotational load to be transmitted to the user's hand.

Results: All 43 patients were male construction workers who sustained an isolated spiral fracture of the shaft of the right fourth metacarpal. None of the fractures was significantly displaced or required surgical fixation. Each case was managed conservatively with immobilization, and all patients achieved excellent short-term functional recovery with a full return to work.

Conclusions: This study identifies a unique occupational injury mechanism producing an isolated spiral fracture of the right fourth metacarpal shaft in construction workers using power drills. Recognizing this pattern can aid clinicians in instituting effective conservative management and underscores the need for improved occupational safety training and preventive strategies.