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