Évaluation du coût des fractures du col du cinquième métacarpien : traitement orthopédique et chirurgical

Kadlub, Natacha; Danino, A.; Trost, O.; Robe, N.; Malka, G.

doi:10.1016/j.main.2006.07.031

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…Some authors recommend routine implant removals, even at the 6 th week. [ 18 ] Our implant removal protocol, like Zeng’s,[ 10 ] was based on complaints of the patients.…”

Section: Discussionmentioning

confidence: 99%

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

Uzun¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The surgical treatment of fifth metacarpal fractures, especially using Kirschner (K) wire techniques, has recently become popular because it provides for early hand movement. Successful anatomical reduction of the fracture is often achieved with surgery; however, an anatomical reduction cannot always be achieved and, according to 30° oblique radiography, the fracture is fixed with an apex dorsal angulation below 40°. The aim of this study was to evaluate the stability of such fractures postoperatively and compare the two different angulation options that provide early movement of the hand and wrist. METHODS: Thirty consecutive cases of neck fractures of the fifth metacarpal were treated intramedullarly with one K wire. Cases were divided into two groups: One fixed with anatomical reduction (Group 1) and the other (Group 2) fixed in apex dorsal angulation below 40°, according to 30° oblique radiography. Angulation, shortening, and functional outcome as Quick DASH scores and grip strengths were evaluated at 6 months. RESULTS: The mean correction angle was 56.6° (between 30° and 110°) for Group 1 and the residual angle was 0°. The mean correction angle was 42.4° (between 20° and 75°) for group 2 (Figs. 4 and 5) and the residual angle was 23.6° (between 10° and 45°). The mean Quick DASH scores were 1.9 (SD: 1.7) for Group 1 and 5.67 (SD: 2.93) for Group 2 (p<0.05). Grip strength values were similar for both groups. All the patients returned to their previous occupations without any limitations in an average of 4 weeks (SD: 1.4) (range 2–6 weeks). No complications such as correction loosening or shortening were detected. Rotation was not detected during physical examination. CONCLUSION: Our investigation revealed no risk of shortening or rotation of the fracture; the patients were able to return quickly to their everyday activities.

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“…Some authors recommend routine implant removals, even at the 6 th week. [ 18 ] Our implant removal protocol, like Zeng’s,[ 10 ] was based on complaints of the patients.…”

Section: Discussionmentioning

confidence: 99%

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

Uzun¹

2021

Ulus Travma Acil Cerrahi Derg

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“…Although our intervention eliminated the need for follow-up appointments in the clinic, there was no standardized method to assess patient satisfaction with the brace. Based on substantial evidence in existing literature, 9,10,13,22,23 both short- and long-term outcomes are equivalent between the treatments in terms of the range of motion, perception of pain, and patient satisfaction. However, we did not confirm these variables in our specific patient population, given the format of the intervention.…”

Section: Discussionmentioning

confidence: 99%

Reducing Healthcare Costs in the Management of Pediatric Metacarpal Neck Fractures

Beals

Lin

Holstine

et al. 2019

Pediatric Quality &Amp; Safety

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Background:We hypothesize that a quality improvement initiative utilizing a Velcro ulnar gutter brace over traditional casting will impart significant savings without compromising clinical outcomes in the management of small metacarpal neck fractures.Methods:Baseline data on number and treatment regimens of small metacarpal neck fractures were collected starting in October 2015. Velcro ulnar gutter braces were purchased for all orthopedic clinics in December 2016. Patients with <70 degrees of angulation and no rotational deformity of the small finger were eligible to have brace treatment without reduction of the fracture. Data were collected each month on several patients managed by Velcro ulnar gutter brace.Results:Three hundred twelve pediatric patients met nonoperative guidelines. Before the intervention, patients were casted and followed radiographically for a minimum of 2 orthopedic clinic visits—which total $916.25 in charges. From October 2015 to November 2016, we treated <1% (1/147) of patients with metacarpal neck fractures without casting. Following the implementation of interventions from December 2016 to January 2019, the percentage of patients treated without cast immobilization increased to 54.5% (90/165), with a process mean shift to >65%. These patients did not have a scheduled follow-up or further radiographic evaluation. In the first 26 months of implementation, this decreased healthcare expenditures by $261,846.Conclusions:A quality improvement initiative emphasizing Velcro ulnar gutter brace treatment for pediatric metacarpal neck fractures resulted in a shift away from cast immobilization in >65% of patients, reducing risks and expenses of cast immobilization.

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“…cinquième métacarpien non ou mal réduit expose à des séquelles fonctionnelles importantes [5]. Plusieurs attitudes thérapeutiques sont possibles, il n'y a pas de consensus [6]. Le traitement orthopédique [7] ou fonctionnel [8] consiste à une réduction de la bascule palmaire sous anesthésie locale avec contention jusqu'à la consolidation, néanmoins les risques non négligeables de déplacement secondaire, de raideur et de cal vicieux, limitent ce choix.…”

Section: Discussionunclassified

Embrochage en L de Vives des fractures du col du cinquième métacarpien (À propos de 24 cas)

Marzouki

Elmrini

Elibrahimi

et al. 2009

Chirurgie de la Main

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Évaluation du coût des fractures du col du cinquième métacarpien : traitement orthopédique et chirurgical

Cited by 6 publications

References 13 publications

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

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

Reducing Healthcare Costs in the Management of Pediatric Metacarpal Neck Fractures

Embrochage en L de Vives des fractures du col du cinquième métacarpien (À propos de 24 cas)

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