Boxer's fracture - Revision history

Hoxbox: /* Acute Reduction */

2022-06-01T16:29:20Z

Acute Reduction

← Older revision		Revision as of 16:29, 1 June 2022
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	*Any rotational deformity should be reduced to allow proper hand function (seen as scissoring)		*Any rotational deformity should be reduced to allow proper hand function (seen as scissoring)
	*Angulation >30° in the 4th digit or >40° in the 5th digit should be reduced		*Angulation >30° in the 4th digit or >40° in the 5th digit should be reduced
			*[https://www.youtube.com/watch?v=40irKoUJqsM Video] on how to perform reduction

	{{Metacarpal fracture goals}}		{{Metacarpal fracture goals}}

Rossdonaldson1: /* Diagnosis */

2020-05-02T08:49:36Z

Diagnosis

← Older revision		Revision as of 08:49, 2 May 2020
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	;"Uncomplicated" ~~defined~~ as:		;"Uncomplicated"
	**Minimally displaced		''Defined as:''
	**Closed		*Minimally displaced
	**Isolated injury		*Closed
	**Fracture angulation of <70 degrees		*Isolated injury
			*Fracture angulation of <70 degrees

	==Management==		==Management==

Rossdonaldson1: /* Diagnosis */

2020-05-02T08:48:45Z

Diagnosis

← Older revision		Revision as of 08:48, 2 May 2020
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	===Diagnosis===		===Diagnosis===
	*Typically on plain hand x-ray showing fracture of the 4th or 5th metacarpal		*Typically on plain hand x-ray showing fracture of the 4th or 5th metacarpal
	*"~~'''~~Uncomplicated~~'''~~" defined as:

			;"Uncomplicated" defined as:
	**Minimally displaced		**Minimally displaced
	**Closed		**Closed

Rossdonaldson1: /* Diagnosis */

2020-05-02T08:48:02Z

Diagnosis

← Older revision		Revision as of 08:48, 2 May 2020
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	===Diagnosis===		===Diagnosis===
	*Typically on plain hand x-ray showing fracture of the 4th or 5th metacarpal		*Typically on plain hand x-ray showing fracture of the 4th or 5th metacarpal
	*"Uncomplicated" defined as:		*"'''Uncomplicated'''" defined as:
	**Minimally displaced		**Minimally displaced
	**Closed		**Closed

Rossdonaldson1: /* Evaluation */

2020-05-02T08:46:40Z

Evaluation

← Older revision		Revision as of 08:46, 2 May 2020
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	==Evaluation==		==Evaluation==
	[[File:Neck Fracture of the Fourth Metacarpal Bone.png\|thumb\|Boxer's Fracture (4th metacarpal)]]		[[File:Neck Fracture of the Fourth Metacarpal Bone.png\|thumb\|Boxer's Fracture (4th metacarpal)]]
	[[~~ile~~:Fractured5thMetacarpalHead2018.jpg\|thumb\|Boxer's Fracture (5th metacarpal)]]		[[File:Fractured5thMetacarpalHead2018.jpg\|thumb\|Boxer's Fracture (5th metacarpal)]]
	===Workup===		===Workup===
	*AP and lateral hand x-ray		*AP and lateral hand x-ray

Rossdonaldson1: /* Evaluation */

2020-05-02T08:45:47Z

Evaluation

← Older revision		Revision as of 08:45, 2 May 2020
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	==Evaluation==		==Evaluation==
	[[File:Neck Fracture of the Fourth Metacarpal Bone.png\|thumb\|Boxer's Fracture]]		[[File:Neck Fracture of the Fourth Metacarpal Bone.png\|thumb\|Boxer's Fracture (4th metacarpal)]]
			[[ile:Fractured5thMetacarpalHead2018.jpg\|thumb\|Boxer's Fracture (5th metacarpal)]]
	===Workup===		===Workup===
	*AP and lateral hand x-ray		*AP and lateral hand x-ray

Rossdonaldson1: /* Immobilization */

2020-05-02T08:44:02Z

Immobilization

← Older revision		Revision as of 08:44, 2 May 2020
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	***Shorter ER Stay <ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>		***Shorter ER Stay <ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>
	*Complicated:		*Complicated:
	**Classically, the [[Ulnar Gutter Splint]] has been recommended
	**[[Forearm volar splint]] with extension over the head of the MCP joint provides equal effect and is better tolerated<ref>Hofmeister EP, Kim J, and Shin AY. Comparison of 2 Methods of Immobilization of Fifth Metacarpal Neck Fractures: A Prospective Randomized Study. The Journal of Hand Surgery. 2008; 33(8):1362–1368.</ref>		**[[Forearm volar splint]] with extension over the head of the MCP joint provides equal effect and is better tolerated<ref>Hofmeister EP, Kim J, and Shin AY. Comparison of 2 Methods of Immobilization of Fifth Metacarpal Neck Fractures: A Prospective Randomized Study. The Journal of Hand Surgery. 2008; 33(8):1362–1368.</ref>
			***Classically, the [[Ulnar Gutter Splint]] was recommended

	==Disposition==		==Disposition==

Alexgrohmann: /* Immobilization */

2020-05-01T21:53:56Z

Immobilization

← Older revision		Revision as of 21:53, 1 May 2020
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	*Uncomplicated		*Uncomplicated
	**Buddy taping<ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>		**Buddy taping<ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>
	***Similar functional outcomes those randomized to plaster cast with earlier return to work<ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>		***Similar functional outcomes those randomized to plaster cast with earlier return to work <ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>
			***Similar satisfaction and pain control as those randomized to plaster casting <ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>
			***Shorter ER Stay <ref>Pellatt, R., Fomin, I., Pienaar, C., Bindra, R., Thomas, M., Tan, E., … Keijzers, G. (2019). Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine, 74(1), 88–97. doi: 10.1016/j.annemergmed.2019.01.032 </ref>
	*Complicated:		*Complicated:
	**Classically, the [[Ulnar Gutter Splint]] has been recommended		**Classically, the [[Ulnar Gutter Splint]] has been recommended

Rossdonaldson1: /* Indications for Reduction */

2019-09-18T02:56:11Z

Indications for Reduction

← Older revision		Revision as of 02:56, 18 September 2019
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	{{General Fracture Management}}		{{General Fracture Management}}

	===~~Indications for~~ Reduction===		===Acute Reduction===
	''Contingent upon angulation and rotation''		''Contingent upon angulation and rotation''
	*Any rotational deformity should be reduced to allow proper hand function (seen as scissoring)		*Any rotational deformity should be reduced to allow proper hand function (seen as scissoring)

Rossdonaldson1: /* Management */

2019-09-18T02:29:52Z

Management

← Older revision		Revision as of 02:29, 18 September 2019
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	==Management==		==Management==
	*[[Open fracture]] (emergent surgery)		{{General Fracture Management}}

	===Indications for Reduction===		===Indications for Reduction===