Healing of these types of fractures is good if managed well even if the distal fragment is attached as a free bone graft. In cases with significant displacement of boxer fractures surgical intervention with open reduction and fixation is needed specially if tendon entrapment is suspected. Percutaneous K wires were chosen to minimize the chances of resorption of the distal fragment. In our case, the distal fragment was completely detached from the metacarpal shaft’s periosteum and we decided to replace it as a bone graft. Methods of fixation vary between K wires, lag screws and plate fixation. The General consensus is that surgical intervention is indicated in open fractures, instability and for multiple fractures.
BOXERS FRACTURE FULL
Methods vary from immobilisation in a plaster of Paris ulnar gutter to functional taping with full mobilisation to full dynamic treatment. There is still no agreement about maintaining the position of the boxer fracture post reduction. The Jahss manoeuvre remains the best technique in attempting closed reduction when angulation exceeds the acceptable limits, pseudoclawing or rotational deformities are evident. Some surgeons agree that considerable angulation of up to 70 degrees in these fractures doesn’t seem to affect the hand function and it’s an acceptable practice accordingly to attempt manipulation only if the angulation exceeds 40 degrees. The degree of palmar angulation deemed acceptable in the literature ranges between 20-70 degrees. The management of these fractures is still a matter of debate. Our literature review didn’t yield any reported cases with such presentation. Our case presented with volar displacement, proximal migration of the fractured piece and 180 degrees flipping. The majority of the subcapital metacarpal little finger fractures are displaced with varying degrees of angulation.
Intrinsic muscles lie volar while crossing the MP joint and maintain the flexed metacarpal head posture.
Metacarpal neck fractures usually occur when a clenched MP joint strikes a solid object resulting in dorsal angulation of the apex.
BOXERS FRACTURE PROFESSIONAL
The little finger is notoriously prone to being fractured at the neck, usually as a result of an axial loading from a punching mechanism and hence the name “Boxers fracture’’ was given to it despite the fact that professional boxers rarely get this type of fracture. It tends to occur in the young and active males and is often sustained through aggression. The little finger is the most commonly involved digit with the subcapital fracture accounting for 25% of all metacarpal fractures. Metacarpal fractures account for 18 % of all fractures of the hand and forearm.
0 kommentar(er)
