Hand xrays
Assess angulation
Head-to-neck angle of the metacarpals is normally 15 degrees
Fracture angulation = measured angle minus 15 deg
Angle toleration (below which there is no adverse functional outcome)
2nd MC < 10 deg
3rd MC < 20 deg
4th MC < 30 deg
5th MC < 30-40 deg
Assess rotational alignment by looking for overlap of the 5th over the 4th digit (scissoring or psuedoscissoring)
Assess extensor apparatus
Assess skin integrity
Head-to-neck angle of the metacarpals is normally 15 degrees
Fracture angulation = measured angle minus 15 deg
Angle toleration (below which there is no adverse functional outcome)
2nd MC < 10 deg
3rd MC < 20 deg
4th MC < 30 deg
5th MC < 30-40 deg
Fracture angulation = measured angle minus 15 deg
2nd MC < 10 deg
3rd MC < 20 deg
4th MC < 30 deg
5th MC < 30-40 deg
Non-thumb metacarpal fracture 
Non-thumb metacarpal fractures
Humerus shaft fracture
Head
Humerus shaft fracture 
Neck
Tibial tuberosity fracture
Shaft