![]() Cosmetic concerns including loss of the knuckle or rotational irregularity were reported, but the majority of patients (6/11) reported having forgotten the fracture had ever occurred.įifth metacarpal neck fractures with severe deformity (>70 degrees of angulation) have acceptable functional outcomes following non-surgical treatment. In 91% (10/11), fractures affected the dominant hand and 64% of patients (7/11) were employed in manual labor. All patients (1) scored very good (range 29-30 out of 30 points) on the functional hand scale (2) reported a QuickDASH score of zero (no disability), and (3) had an average or above-average score on the SF-12. Two patients (15%) underwent subsequent corrective surgical treatment and were considered non-surgical treatment failures their outcomes were excluded.ġ1 patients treated non-surgically for fifth metacarpal neck fractures with angulation >70 degrees had telehealth follow-up after fracture consolidation (average follow-up 29.6 months from injury, Table 1). Of the 13 patients remaining, average angulation was 73 degrees (range 71-77). Fifteen of the 28 patients were unable to be contacted. 6% of patients (28/473) had fracture angulation >70 degrees (range 71-82). Radiographs were reviewed in 473 adult patients that met inclusion criteria 1 and 2. Patients were contacted after fracture healing via video telehealth visits and completed three functional scoring surveys (Functional Hand Survey derived from Injury. Inclusion criteria were: (1) patients >18 years of age with isolated, closed fifth metacarpal fractures (2) initial non-surgical treatment (3) healed fractures with angulation >70 degrees as measured on oblique radiographs. This study evaluates clinical outcomes for patients with fifth metacarpal neck fracture angulation >70 degrees treated without fracture reduction or surgical repair.Ī retrospective review of electronic medical records at two, academic, tertiary-care hospitals identified patients with fifth metacarpal neck fractures treated between and utilizing ICD-9/10 and CPT codes. Consensus treatment recommendations for severe angulation greater than 70 degrees is lacking. The clinically acceptable angular deformity of fifth metacarpal neck fractures (Boxers fracture) has been reported up to 70 degrees, with studies reporting reasonable functional outcomes with this amount of angulation or less. Thomas France, MD, University of Colorado SOM, Aurora, CO, Alexander Lauder, MD, Denver Health Medical Center, Denver, CO and Fraser Leversedge, MD, University of Colorado Health, Aurora, CO Clinical Outcomes in Severely Angulated Fifth Metacarpal Neck Fractures ![]()
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