Functional treatment of metacarpal fractures: 100 randomized cases with or without fixation

Konradsen, Lars; Nielsen, Poul; Albrecht‐Beste, Elisabeth

doi:10.3109/17453679008993576

Cited by 66 publications

(59 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is also unclear as to what amount of volar angulation and axial shortening is acceptable [6,9,11,15,20,22,27,30,31,34]. In the present study, we obtained subjectively good results with no pain and objectively good mobility and strength, at a mean of 5 months after the fracture.…”

Section: Discussionsupporting

confidence: 62%

“…This observation suggests that these fractures were stable. Closed reduction might displace a stable fracture, and in other studies, all fractures that had been reduced lost reduction irrespective of the type of immobilization [5,14,19,20,22,23]. Consequently, reduction of a subcapital fracture of the fifth metacarpal is not necessary, and early mobiliza- Table 2 Angulation and shortening of the fifth metacarpal fractures at the beginning and at the end of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…These fractures are usually sustained by an axial blow on the metacarpophalangeal (MCP) joint in a flexed position, hence, the name boxer's fracture. The degree of acceptable volar angulation varies from 20 to 70° [6,9,11,15,20,22,27,30,31,34], and the ideal treatment for this fracture is still a matter of debate. Treatment options include operative procedures, splinting with or without closed reduction, and functional taping.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcome of Boxer's Fractures Treated by a Soft Wrap and Buddy Taping: A Prospective Study

Aaken

Kampfen

Berli

et al. 2007

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Introduction The ideal treatment for a boxer's fracture remains controversial, particularly the degree of volar dislocation considered acceptable for nonoperative treatment. Patients and Methods From December 2003 to December 2004, 25 patients who sustained a subcapital metacarpal fracture of the little finger with volar angulation between 30 to 75°were prospectively enrolled in the study. All patients were treated with a circular self-adherent wrap covering metacarpal bones II-V and buddy taping of the ring and little fingers for a period of 3 weeks while allowing immediate free range of motion.Results Final evaluation at a mean of 5 months revealed all patients to be satisfied without subjective functional impairment. All fractures healed, and the angulation of the fracture remained unchanged, but moderate shortening was observed. Active flexion of the metacarpophalangeal (MCP) joint was significantly lower on the fracture side, but as the median degree of MCP flexion was the same, this statistical difference was without clinical relevance. There was no loss in grip strength. A subjective long-term evaluation was performed by phone; at a median of 3 years, a QuickDash score gave a median of 0 point. Conclusion Treating a boxer's fracture with angulation of up to 75°by soft wrap and buddy taping resulted in satisfied patients and good clinical results.

show abstract

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome of Boxer's Fractures Treated by a Soft Wrap and Buddy Taping: A Prospective Study

Aaken

Kampfen

Berli

et al. 2007

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

“…Although reduction is very easy to obtain, immobilization is frequently unable to maintain reduction with conservative treatment, due to the combination of the palmar region of the metacarpal neck and the intrinsic muscles that act in the distal fragment. 20,21,[24][25][26] It was demonstrated that surgical treatment affords better correction of angulation than conservative treatment with reduction and immobilization.6 The treatment was described by Bosworth,27 in 1937, and used K-wires to fix the fifth metacarpal head and diaphysis to the fourth metacarpal bone. Retrograde osteosynthesis with crossed K-wires, described by Smith and Peimer, 28 31 demonstrated that totally pivoting control at the axis of the distal wire is essential to obtain fixation of two points in the two diaphyseal fragments.…”

Section: Discussionmentioning

confidence: 99%

Colocação segura de pinos percutâneos em fraturas subcapitais do quinto metacarpo: um estudo anatômico

Polat¹,

Cömert²,

Atalar

et al. 2011

Acta ortop. bras.

View full text Add to dashboard Cite

ABSTRACT2EMHFW×YHV :KHQ WUHDWLQJ FORVHG IUDFWXUHV RI WKH QHFN RI WKH little finger metacarpal (boxer fractures) with percutaneous transverse K-wire fixation and other procedures, there may be iatrogenic injury to the dorsal digital branch to the little finger (DDBLF) of the dorsal branch of the ulnar nerve (DBUN). In this study we aimed to describe the relationship of the DDBLF of the DBUN and the insertion points on the external side of the fifth metacarpal during percutaneous transverse K-wire fixation of subcapital fractures. Methods: Dissections and measurements regarding this branch were performed after percutaneous transverse pinning to distal part of fifth metacarpal bones in ten cadaver hands formalin fixed. Results: The results of this study confirm the close proximity of the trajectory of the with this branch and demonstrate its potential iatrogenic injury during K-wire fixation of the fifth metacarpal. Conclusions: To avoid penetration of this nerve and limit the chances of iatrogenic injury it is important to know its course. The authors describe the anatomical insertion points and believe that using the anatomical knowledge, subcapital fifth metacarpal fractures can be treated without risk of sensory deficits.

show abstract

“…As the problems listed above show that wearing a cast impacts with the patient's life, and overall experience of the care. With the growing demand for better patient care, studies completed by (Carl R. Chudnofsky 2010;Kelly 2015;Konradsen, Nielsen & Albrecht-Beste 2009) that show an increased recovery rate with an earlier rehabilitation initialization, as well as the ability to use everyday events as rehabilitation, all lead to a better patient experience as well as reduced healing time.…”

Section: Introductionmentioning

confidence: 99%

Design of a Patient Specific, 3D printed Arm Cast

Fitzpatrick¹,

Mohanned²,

Collins³

et al. 2017

KEG

View full text Add to dashboard Cite

3D printing is a manufacturing technique by which the material is added layer by layer to create a physical three-dimensional object. This manufacturing technique had primarily found uses in academic and commercial sectors for prototyping and product realization purposes. However, more recently the home consumer market has seen a surge in low cost printers bringing this capability to the masses. More recently 3D printing has seen considerable interest from the clinical sector, where alongside the synergistic use with medical imaging data, a whole generation of patient specific implantable technologies, splints/casts and resection guides can be created. Predominantly, clinical applications have focused on the use of 3D printing for bone replacement, however with the advent of more sophisticated multi-material printers, interest has now begun to move to applications in orthotics and orthopedic casting.This study is to review and evaluate the feasibility of designing and realizing a more patient specific orthopedic cast to surpass current limitation with traditional fiberglass/plaster casts, through the use of advanced 3D modelling and printing techniques. To directly compare the efficacy of the traditional and 3D printed casts, we shall investigate critical parameters such as the time for manufacture, the overall weight of the final product, the accuracy off the cast relative to the patient’s unique anatomy and additional user-centric metrics (comfort, aesthetics, etc.). The design examined made use of advanced mesh structures throughout the bulk of the cast, such that the device would require less material (by weight) during fabrication, could allow for tunable weight and mechanical properties and allow for air penetration to the person skin, thereby reducing discomfort due to prolonged moisture exposure (chaffing, bad smells, etc.). As the primary focus of this study is the design and product realization phases and we shall not assess metrics relating to patient recover time or experience.Overall it was found that the 3D printed cast was significantly lighter, with improved water repellent and air circulation properties, as compared to a traditional cast. Through the use of high precision design/manufacturing techniques, the final device could be accurately reproduced to match the test patient’s unique anatomy, thereby optimizing the orientation of the patient’s bones during post fracture recovery. It was however found that the manufacturing time for the 3D printed cast was slower than traditional casting methods owing to the additional time during the design phase. In future work we aim to address this limitation and to devise a streamlined methodology such that a generic cast design can be adapted to patient specific anatomical data through parametric design algorithms.Ultimately, it was found that through the use of advanced design techniques, patient specific data and 3D printing, a custom orthopedic cast could be realized and with significant potential to augment current use of this technology for surgical intervention and improve patient outcomes. The use of advanced manufacturing in the medical field will likely enable more patient specific/user-centric treatment in the near future.

show abstract

Functional treatment of metacarpal fractures: 100 randomized cases with or without fixation

Cited by 66 publications

References 12 publications

Outcome of Boxer's Fractures Treated by a Soft Wrap and Buddy Taping: A Prospective Study

Outcome of Boxer's Fractures Treated by a Soft Wrap and Buddy Taping: A Prospective Study

Colocação segura de pinos percutâneos em fraturas subcapitais do quinto metacarpo: um estudo anatômico

Design of a Patient Specific, 3D printed Arm Cast

Contact Info

Product

Resources

About