FIFTH METACARPAL FRACTURES

Course overview

METACARPAL FRACTURES ACCOUNT FOR 40% OF ALL HAND FRACTURES. A FRACTURE OF THE NECK OF THE FIFTH METACARPAL, OR BOXER'S FRACTURE, NAMED FOR THE CLASSIC MECHANISM OF INJURY IN WHICH DIRECT TRAUMA IS APPLIED TO A CLENCHED FIST, IS THE MOST COMMON, REPRESENTING 10% OF ALL HAND FRACTURES. TREATMENT FOR A BOXER'S FRACTURE VARIES BASED ON WHETHER THE FRACTURE IS OPEN OR CLOSED, THE DEGREE OF ANGULATION, ROTATION, AND OTHER CONCOMITANT INJURIES. IMMOBILIZATION WITH AN ULNAR GUTTER SPLINT MAY BE THE DEFINITIVE TREATMENT FOR CLOSED, NON-DISPLACED FRACTURES WITHOUT ANGULATION OR ROTATION, WHILE OPEN FRACTURES, SIGNIFICANTLY ANGULATED OR MALROTATED FRACTURES OR THOSE INVOLVING INJURY TO NEUROVASCULAR STRUCTURES REQUIRE REFERRAL TO A HAND SURGEON. THIS ACTIVITY REVIEWS THE ETIOLOGY, PRESENTATION, EVALUATION, AND MANAGEMENT OF BOXER'S FRACTURE, AND REVIEWS THE ROLE OF THE INTERPROFESSIONAL TEAM IN EVALUATING, DIAGNOSING, AND MANAGING THE CONDITION.