Treating the boxer's fracture in Wales: a postal survey.
BACKGROUND
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.


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 masculine of displacement, 29% at 40 masculine, 18% at 50 masculine and 20% at 60 masculine 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.
Jones
Rhidian
R
Department of Orthopaedics, Wrexham Maelor Hospital, Wrexham, UK. rhidianjones@hotmail.com
Burdett
Sadie
S
Jefferies
Matthew
M
Guha
Abhijit R
AR
D001914:Boxing / Q000293:injuries*; D002370:Casts, Surgical / Q000706:statistics & numerical data; D005592:Fracture Fixation / Q000379:methods* / Q000706:statistics & numerical data; D050723:Fractures, Bone / Q000473:pathology*; D019538:Health Care Surveys; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D050279:Metacarpal Bones / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D011364:Professional Practice / Q000706:statistics & numerical data; D014852:Wales