Fracture of the Neck of the Fifth Metacarpal (Boxer's Fracture)

Master the surgical treatment of fifth metacarpal neck fractures, known as "boxer's fractures," especially when the angulation exceeds 40 degrees. This training offers a technical immersion in reduction and fixation with a double compression screw, using a minimally invasive approach to optimize patient recovery.

Training Focus:

• Treatment of fifth metacarpal neck fractures with angulation greater than 40 degrees.
• Double compression screw fixation technique.
• Minimally invasive surgical approach.
• Preoperative planning based on X-rays.
• Precise guide wire insertion and bone drilling.

Detailed Content:

• X-ray Evaluation and Precise Planning: Learn to interpret X-rays to identify the surgical indication. Master the pre-operative markings with a dermographic pen, aligning them with the diaphysis of the fifth metacarpal in the anteroposterior (AP) and lateral projections to guide the direction of the guide wire.
• Strategic and Minimally Invasive Surgical Access: Develop the skill to perform a transverse incision of approximately 1.5 cm on the skin, perpendicular to the direction of the extensor tendon of the fifth finger. Understand the importance of blunt dissection, using a blunt Metzenbaum scissors, along the direction of the tendon fibers to minimize tissue trauma.
• Optimized Guide Wire Insertion: Learn how to insert the guide wire based on the pre-operative markings, ensuring precise alignment in the anteroposterior, lateral, and oblique projections.
• Measurement and Directional Drilling: Learn to perform precise measurements to determine the appropriate screw size after confirming the positioning of the guide wire, and drill directly over the guide wire.
• Insertion of Double Compression Screw: Master the technique of inserting the double compression screw through the guide wire, following the guidelines established in manuals such as the AO's.
• Final Confirmation and Accelerated Recovery: Understand the criteria for the final confirmation of the reduced fracture and the screw positioned extra-articularly. The minimally invasive technique ensures a very satisfactory recovery, avoiding extensive skin incisions and more aggressive approaches, with skin closure performed with only two stitches.

Included Material:

• Detailed Technical PDF: A comprehensive educational document that describes the surgical procedure for treating the fracture of the fifth metacarpal neck, from the initial radiographic assessment to surgical closure.

Enhance your hand surgery skills. Enroll now and master advanced techniques in treating the boxer’s fracture, ensuring precise results and optimized recovery for your patients.