Virtual Conference
Grigorios Kastanis

Grigorios Kastanis

General Hospital of Heraklion Venizeleio, Greece

Title: Assessment of the functional outcomes and complications rate from the surgical treatment of unstable subcapital fracture of the fifth metacarpal according to a new classification system based on fracture pattern


The fifth metacarpal neck fractures or Boxer fracture is the most common injury of upper extremity treated in the emergency department. Due to the complex structures and special function of the hand the treatment of unstable boxer fractures that required surgical intervention has always been one of the intricate problems in orthopaedic regarding the surgical procedures. The purpose of this study is to analyze the functional results and complication rate of Boxer fractures treated with low profile plates based to a new classification system of the boxer fractures.

Material & Methods

Between 2015 - 2019, 125 patients with an average of 29 years old (range 20 - 54 years old) undergone for surgical treatment for unstable neck of 5th metacarpal. In four cases the fracture was bilateral and in seven cases the fractures were open. We classified all these fractures in three categories based on the fracture pattern. (Image 1,2,3) The indications for operative fixation were: angulations more than 40º, rotatory malalignment, shortening>3 mm, failure to maintain reduction.


The average follow - up was 17 months (range 13-32 months). The D.A.S.H. score, Total Active Motion of the digit, radiographic parameters, complication rates, time to return to work were the measures to evaluate the outcomes. At the final examination the median D.A.S.H. score was 7,9, the median T.A.M. 239º, period to radiographic healing was 4,6(range from 4,2 to 7,8) weeks. Among the complication were 4 cases with superficial infection, 3 cases with malunion, 3 cases with implant failure, and 1 case with complex regional pain syndrome


Open reduction and internal fixation with low profile plates of Boxers fractures   is an alternative type of osteosynthesis which offer good functional results achieving the goal of surgical treatment which is the full range of motion and the regaining of previous functional mobility.