![]() ![]() Only one review on the same topic was performed in 2008. 2012).Īs indicated by Cooper and Wietlisbach ( 2014), hand rehabilitation is important to ensure optimal hand function post-surgery and during conservative management of second to fifth metacarpal fractures (Cooper & Wietlisbach 2014). Metacarpal fractures frequently occur when the hand makes contact with a solid surface, during falls and in motor vehicle accidents (Nakashian et al. The IR of metacarpal fractures is higher amongst males (IR 28.4) than in females (IR 4.4). 2012), and boxer’s fractures, break of the fifth metacarpal bones, account for 20% of all hand fractures (Ali, Hamman & Mass 1999). An incidence rate (IR) for metacarpal fractures is 13.6 per 100 000 with a prevalence of 33% in the United States of America (Nakashian et al. Privacy Policy.Metacarpal fractures are amongst the most prevalent upper limb injuries in adults (Bucholz 2009). ![]() © 2023 American Association for Hand Surgery. Further studies are needed to explore outcomes after operative and non-operative management of the various patterns of fracture at the base of the fifth metacarpal. Unfortunately, functional outcomes were limited due to poor patient follow-up. Articular involvement and fracture displacement had a significant effect on the decision to operate, while fracture comminution did not. This study demonstrates that these fractures occur in a wide variety of patterns, and that particular features may increase the need for operative management. Comminution had no significant effect on whether a fracture was managed operatively or non-operatively, p=0.57.Ĭonclusions: Although fractures of the base of the fifth metacarpal occur relatively frequently, there is no consensus for appropriate treatment. Similarly, fully displaced fractures required operative treatment significantly more often than minimally displaced or nondisplaced fractures, p=0.047. Intra-articular fractures of the 5 th metacarpal were significantly more likely to require operative management than extra-articular fractures, p=0.015. 18.9% of patients underwent operative treatment. 64.9% were intra-articular fractures and 43.1% were comminuted fractures. Of the fractures, 17.7% were fully displaced, 44.6% were minimally displaced and 29.7% were non-displaced. Average follow-up time was 35.19 ± 56.86 days, and 39.1% of patients lost to follow-up. 71.6% of patients were male and 28.4% were female. Results: Most common mechanism of injury was punch (41.9%), fall (29.7%), and MVC (17.6%). Fracture patterns were analyzed using Pearson's Chi-Squared Test to determine whether each variable influences operative vs. Patient demographics, mechanism of injury, intra- versus extra-articular, comminution, displacement, non-operative and operative treatment, time to surgery and follow-up time were collected. Materials and Methods: A retrospective chart review was performed of 74 patients with fractures at the base of the 5 th metacarpal seen within a 5 year period (2011-2016). This study aims to evaluate the incidence, distribution, mechanism of injury and treatment of fractures of the base of the 5 thmetacarpal, to further improve the management of such injuries. Despite the relatively common occurrence of this fracture, there is a paucity of evidence in the literature regarding patterns of injury and optimal treatment for fracture of the base of the 5 th metacarpal 3,4. The 5 th metacarpal is the most commonly fractured metacarpal, and fracture of the base is second only to metacarpal neck fractures 2. Introduction: Fractures of the metacarpals encompass 18-44% of all hand fractures 1. Rhode Island Hospital and Alpert Medical School of Brown University, Providence, RI William K Snapp, MD Geoffrey Hogan, BS Adnan Prsic, MD Jonathan Bass, MD Scott Schmidt, MD Reena A Bhatt, MD Fractures at the Base of the Fifth Metacarpal: Epidemiology and Radiograchic Features ![]()
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