Metacarpal Neck Fractures By Danielle Campagne, MD, University of California, San Francisco Reviewed / Revised Dec 2022 View Patient Education Diagnosis Treatment Key Points Topic Resources Rotational deformity due... Metacarpal Neck Fracture Fracture of the 5th Metacarpal... Ulnar gutter splint How To Apply an Ulnar Gutter... Metacarpal neck fractures usually result from an axial load (eg, from punching with a clenched fist).