Case Of the Week (COW) 19 May 2013
Answer:
Boxer's Fracture.
Findings:
Fracture of neck of 5th metacarpal with volar angulation.
Discussion:
Boxer's fracture is a transverse fracture of neck of fifth metacarpal with volar angulation and is the most common metacarpal fracture.
It occurs due to axial loading and is almost always the consequence of a direct blow with clenched fist against a solid surface. The degree of palmar angulation is best assessed on lateral radiograph, with lines drawn through the medullary canal. When this is not possible the oblique view can be used, however this results in less accurate measurements which tend to overestimate the degree of angulation. Although it can be treated conservatively, it is relatively unstable, and K-wire fixation is often required for better cosmetic results.
Contributed By:
Dr. Aravindan Selvaraj MS (Ortho), FRCS, Dr. Iyappan Ponnuswamy MD(RD), FRCR, Dr. Sushila Krishnan DMRD, DNB, Dr. Ramesh D.Ortho, MD(RD)
Kauvery Hospital, Alwarpet, Chennai
Answer:
Boxer's Fracture.
Findings:
Fracture of neck of 5th metacarpal with volar angulation.
Discussion:
Boxer's fracture is a transverse fracture of neck of fifth metacarpal with volar angulation and is the most common metacarpal fracture.
It occurs due to axial loading and is almost always the consequence of a direct blow with clenched fist against a solid surface. The degree of palmar angulation is best assessed on lateral radiograph, with lines drawn through the medullary canal. When this is not possible the oblique view can be used, however this results in less accurate measurements which tend to overestimate the degree of angulation. Although it can be treated conservatively, it is relatively unstable, and K-wire fixation is often required for better cosmetic results.
Contributed By:
Dr. Aravindan Selvaraj MS (Ortho), FRCS, Dr. Iyappan Ponnuswamy MD(RD), FRCR, Dr. Sushila Krishnan DMRD, DNB, Dr. Ramesh D.Ortho, MD(RD)
Kauvery Hospital, Alwarpet, Chennai