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Management of Fifth Metacarpal Fractures in Pediatric Patients
Suma Yalamanchili MD, Nathaniel Roberson BS, Maleeh Effendi, MD, Ann Schwentker MD
Academic Medical Center
2020-02-14
Presenter: Suma Yalamanchili
Affidavit:
100% of the work represents the original work of the resident
Director Name: Ann Schwentker, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Purpose: The purpose of this study is to investigate the management of fifth metacarpal fractures treated in the pediatric population at an academic pediatric hospital.
Background: Hand fractures that present to the emergency room are commonly managed non-operatively with closed reduction. There is a paucity of data reporting on outcomes for hand fractures that were initially treated conservatively. Our study seeks to investigate the intervention(s) required in the treatment of pediatric hand fractures.
Methods: This is a retrospective chart review of pediatric patients treated at Cincinnati Children's Medical center for fifth metacarpal fractures. This includes patients who were seen solely by the emergency department providers or for whom consulting services such as plastic surgery or orthopedic surgery were consulted.
Results: 83 patients were identified during our time period. 31 patients (37.3%) were seen by a consulting service (plastic or orthopedic surgery) and 52 patients (62.7%) were not seen by a consulting service. 7/52 patients seen only by the emergency department underwent closed reduction and none required re-reduction in clinic or operative intervention. 24/31 patients (77.4%) seen by a hand surgery service underwent closed reduction in the emergency department. Of the 19 patients who followed up in clinic, one patient (5.3%) required repeat reduction in the clinic and four patients (21.1%) underwent definitive operative management.
Conclusions: The majority of patients who present to the emergency room with fifth metacarpal fractures are not seen by a consulting hand service. However, when a consulting service is called, closed reduction is commonly performed.
