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Multicenter Study
. 2010 Apr;92(3):236-9; quiz 239.
doi: 10.1308/003588410X12628812458176. Epub 2010 Mar 10.

Treating the boxer's fracture in Wales: a postal survey

Rhidian Jones  1 , Sadie Burdett, Matthew Jefferies, Abhijit R Guha
Affiliations
Multicenter Study

Treating the boxer's fracture in Wales: a postal survey

Rhidian Jones et al. Ann R Coll Surg Engl. 2010 Apr.

Abstract

Introduction: There is no standardised treatment for fifth metacarpal neck fractures. Treatment of this common fracture can vary from immediate mobilisation to immobilisation in a plaster cast for 3 weeks. There is no literature identifying current practice amongst surgeons.

Subjects and methods: This survey's aim was to reveal current practice in Wales by means of a postal questionnaire sent to all Welsh orthopaedic consultants.

Results: The questionnaire had a 60% response rate. Results demonstrated varied opinion regarding the degree of displacement warranting reduction. Overall, 10% of surgeons reduce the fracture at 30 masculine of displacement, 29% at 40 masculine, 18% at 50 masculine and 20% at 60 masculine of displacement. The treatment was also very varied. Most surgeons preferred to treat these fractures with neighbour strapping (43%,) while others preferred plaster immobilisation (39%) or immediate mobilisation (10%.) Only 22% of surgeons discharge these patients back to the community after their first visit to out-patients while 13% offer two follow-up appointments.

Conclusions: The treatment being offered for this common fracture in Wales is inconsistent. There is a need to develop evidence-based best practice guidelines which should standardise the treatment of this common injury. Perhaps, a large multicentre outcome study may enable this to be drawn up in the future.

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Figures

Figure 1
Figure 1
Angle of displacement at which consultants reduce fracture.
Figure 2
Figure 2
Angle of displacement requiring reduction comparing general orthopaedic surgeons to hand/upper limb specialists.
Figure 3
Figure 3
Treatment according to specialist or general orthopaedic surgeon. POP, plaster of Paris.
See this image and copyright information in PMC

Comment in

  • Comment on: boxer's fracture.
    Smith KR. Smith KR. Ann R Coll Surg Engl. 2010 Jul;92(5):449. doi: 10.1308/003588410X12699663904033. Ann R Coll Surg Engl. 2010. PMID: 20626990 Free PMC article. No abstract available.

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