Cambridge Plastic Surgery

Plastic and reconstructive surgery, hand surgery and aesthetic surgery

Medicolegal reporting



Metacarpal boss

A metacarpal boss is formed from a spur of bone at the base of a metacarpal bone, and at the edge of a wrist bone. It can be associated with recurrent trauma across the affected carpo-metacarpal joint.


Patients normally report the presence of a hard painful lump on the back of their wrist.


The diagnosis can usually be made in clinic after listening to the history and after examination of the patient. A lateral x-ray of the wrist, with views of the prominent lump, should confirm the diagnosis.


Activity modification: Most patients will report a specific activity, which brings on the pain (such as golf or cycling). In many of these patients a change in the posture of their wrist during the index activity, will result in a tolerable reduction in pain.
Steroid injection: Some patients report a reduction in discomfort after injection of steroid into the metacarpal boss.
Waiting: Some clinical reports suggest that the discomfort will reduce in many patients after about 10 weeks.


This is usually as a short day-case procedure. A transverse incision is made over the lump allowing removal of the bone spurs. The wrist is then supported in a padded dressing for about 10 days. There is a risk of infection, bleeding, swelling, stiffness, pain and recurrence.

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