Citation

Jones R, Burdett S, Jefferies M, Guha A. Ann. R. Coll. Surg. Engl. 2010; 92(3): 236-239.

Copyright

(Copyright © 2010, Royal College of Surgeons of England)

DOI

10.1308/003588410X12628812458176

PMID

20223051

PMCID

PMC3080065

Abstract

INTRODUCTION There is no standardised treatment for fifth metacarpal neck fractures. Treatment of this common fracture can vary from immediate mobilisation to immobilisation in a plaster cast for 3 weeks. There is no literature identifying current practice amongst surgeons. SUBJECTS AND METHODS This survey's aim was to reveal current practice in Wales by means of a postal questionnaire sent to all Welsh orthopaedic consultants. RESULTS The questionnaire had a 60 percent response rate. Results demonstrated varied opinion regarding the degree of displacement warranting reduction. Overall, 10 percent of surgeons reduce the fracture at 30 degrees of displacement, 29 percent at 40 degrees, 18 percent at 50 degress and 20 percent at 60 degrees of displacement. The treatment was also very varied. Most surgeons preferred to treat these fractures with neighbour strapping (43 percent,) while others preferred plaster immobilisation (39 percent) or immediate mobilisation (10 percent.) Only 22 percent of surgeons discharge these patients back to the community after their first visit to out patients while 13 percent offer two follow up appointments. CONCLUSIONS The treatment being offered for this common fracture in Wales is inconsistent. There is a need to develop evidence based best practice guidelines which should standardise the treatment of this common injury. Perhaps, a large multicentre outcome study may enable this to be drawn up in the future.

Language: en