Boxer's fracture: Difference between revisions
No edit summary |
No edit summary |
||
| Line 5: | Line 5: | ||
*Pain or swelling along the fourth or fifth metacarpals | *Pain or swelling along the fourth or fifth metacarpals | ||
*Volar angulation of metacarpal or "missing 4th/5th knuckle" | *Volar angulation of metacarpal or "missing 4th/5th knuckle" | ||
*Always look for areas of skin breakdown, as these may signify a [[ | *Always look for areas of skin breakdown, as these may signify a fight bite that can result in a [[closed fist infection]] if untreated | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hand and finger fractures DDX}} | {{Hand and finger fractures DDX}} | ||
==Diagnosis== | |||
[[File:Neck Fracture of the Fourth Metacarpal Bone.png|thumb|Boxer's Fracture]] | |||
*AP and lateral hand radiographs | |||
==Management== | ==Management== | ||
| Line 19: | Line 19: | ||
**Any rotational deformity should be fixed to allow proper hand function. | **Any rotational deformity should be fixed to allow proper hand function. | ||
**10 degrees of angulation is tolerated in the 1st and 2nd metacarpals, while the third and fourth metacarpals can tolerate up to 40 degrees of angulation. | **10 degrees of angulation is tolerated in the 1st and 2nd metacarpals, while the third and fourth metacarpals can tolerate up to 40 degrees of angulation. | ||
==See Also== | ==See Also== | ||
*[[Non-thumb metacarpal fractures]] | *[[Non-thumb metacarpal fractures]] | ||
==References== | |||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 16:24, 10 November 2015
Background
- Fracture of the fourth or fifth metacarpal bones caused by an axial load, typically from punching a person or object.
Clinical Features
- Pain or swelling along the fourth or fifth metacarpals
- Volar angulation of metacarpal or "missing 4th/5th knuckle"
- Always look for areas of skin breakdown, as these may signify a fight bite that can result in a closed fist infection if untreated
Differential Diagnosis
Hand and Finger Fracture Types
Diagnosis
- AP and lateral hand radiographs
Management
- Indications for reduction are contingent upon angulation and rotation.
- Ulnar Gutter Splint
- Any rotational deformity should be fixed to allow proper hand function.
- 10 degrees of angulation is tolerated in the 1st and 2nd metacarpals, while the third and fourth metacarpals can tolerate up to 40 degrees of angulation.