Jason, a 26-year-old male, presents to the emergency department with pain and swelling in his right hand. He reports immediate pain and difficulty moving his fingers. He denies any numbness, tingling, or open wounds. The pain is localized to the knuckle area of his right hand and worsens with movement. Medical History: No significant past medical history. No history of previous hand injuries. Social History: Works as a warehouse manager, frequently lifting heavy objects. Smokes occasionally; no alcohol use on the day of injury. Physical Examination: Inspection: Swelling over the dorsal aspect of the right hand, particularly over the fifth metacarpal. Depression of the fifth knuckle. No open wounds or bruising. Palpation: Tenderness over the neck of the fifth metacarpal. No crepitus or palpable step-off. Range of Motion: Limited flexion and extension of the fifth finger due to pain. Fingers align properly when making a fist. Neurovascular Status: Capillary refill <2 seconds.Sensation intact in all fingers. Diagnostic Workup: 1.X-ray (AP, lateral, oblique views): Fracture at the neck of the fifth metacarpal with 35° dorsal angulation.No shortening or rotational deformity. What is the most common mechanism of injury for this fracture?
