“Bouquet technique” for displaced boxers fracture: Surgical technique and outcomes in143 consecutive cases

Abstract

Background: Fifth metacarpal neck fractures, also known as Boxer's fractures, commonly occur as a result of axial impact on a clenched fist. There is no agreement over the optimum management of undisplaced boxers fracture. We present the results of treatment by a Bouquet technique, described by Foucher in 143 consecutive cases of displaced fifth metacarpal neck fractures. Methods: We retrospectively reviewed our records for 143 consecutive cases of fifth metacarpal neck fractures treated with Bouquet technique. Clinical and radiological evaluation was done at 6 weeks, 12 weeks and 6 months. Total active motion of the fifth digit, radiography and complications if any were noted. Results: Of 143 cases, there were 113 cases with closed reduction and 30 with open reduction. Radiological union was achieved in 140 cases. Remaining 3 were lost to follow up. Good to excellent result was achieved in 95% cases. Seven cases developed bursitis at the K-wire entry site which required k-wire removal. Conclusion:The technique of flexible antegrade intramedulary nailing of fifth metacarpal neck fractures is simple, safe, soft tissue sparing, minimally invasive technique giving excellent functional and cosmetic results with minimal complications.

Early movement does not cause loss of reduction in surgically treated boxer fractures

“…It is often seen as a palmar angulation and is seldom comminuted. [ 1 ] Successful results can be achieved with conservative treatment, as reported in the literature; however, impatient or restless patients with this kind of injury can find it difficult to live with a cast and cause unintentional self-harm. [ 2 , 3 ] Patients sometimes attempt to remove the cast themselves within a few days of their treatment, which causes worse displacement of the fracture and can result in esthetic sequelae and lack of extension at the metacarpophalangeal (MCP) joint.…”