Affiliation:
1. Department of Orthopaedics, Wrexham Maelor Hospital Wrexham, UK
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% response rate. Results demonstrated varied opinion regarding the degree of displacement warranting reduction. Overall, 10% of surgeons reduce the fracture at 30° of displacement, 29% at 40°, 18% at 50° and 20% at 60° of displacement. The treatment was also very varied. Most surgeons preferred to treat these fractures with neighbour strapping (43%,) while others preferred plaster immobilisation (39%) or immediate mobilisation (10%.) Only 22% of surgeons discharge these patients back to the community after their first visit to out-patients while 13% 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.
Publisher
Royal College of Surgeons of England
Cited by
8 articles.
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