الفهرس | Only 14 pages are availabe for public view |
Abstract Fractures of the metacarpal bones are very common injuries of the skeletal system and, in approximately 50% of the cases, involve the neck of the fifth metacarpal bone. The Metacarpal neck fractures are among the most common of hand fractures with those involving the fifth metacarpal (boxer’s fractures) being the most common. These fractures result from a longitudinal compression force acting on a flexed metatarsophalangeal joint usually when a clenched fist strikes a solid object, the resultant fracture is usually unstable with volar angulation due to commination of the volar cortex and the deforming action of the interossei. These fractures are frequently observed in active young men, occur in the dominant hand and are typical injuries of aggression (boxer’s fractures).their treatment can be problematic ,many treatments are numerous: functional treatment by a simple syndactylisation with risk of secondary displacement;the Conservative treatment consists of a cast immobilization, but sometimes source of skin complications, and there are Various fixation techniques in use are: a direct osteosynthesis; percutaneous pinning ; plating and percutaneous transverse pinning . The management of boxer’s fracture is still Controversial, Various operative techniques have been proposed for the surgical treatment of these fractures,the principles of treatment include restoration of articular anatomy, stable fixation of fractures, elimination of angular or rotational deformity and rapid restoration of mobility and function. Although Flexible intramedullary nailing is indicated for any displaced or unstable fracture of the metacarpal neck. |