2. HPI - A 17-year-old male comes to the clinic on a Friday afternoon,
complaining of pain and swelling along the outer aspect of his right
hand. He had gotten into an argument with his girlfriend and, out of
frustration, punched the wall.
PMX- ADHD
PSX- None
Allegies- none
Meds- None
FX- HTN
3. P- 102 BP- 134/86, RR- 18 T-98.8
HEENT- NCAT, EMOI
Cardio- S1, S2
RESP- CTAB
EXT- pain with palpation and swelling at the base of
the small finger. There is bump over the back of the
palm just below the small finger knuckle.
4.
5.
6. Definition: The boxer's fracture is a broken bone of
the hand, most often at the base of the small finger,
along the metacarpal neck.
An acceptable reduction is lateral angulation less
than 30-40 degrees
No rotational angulation is acceptable (as seen on
AP view)
Boxers Fractures with unacceptable degrees of
reduction will require percutaneous pin fixation to
prevent a functional deficit (pseudoclawing)
7. Ulnar Gutter splint
Reduction
90-90 Reduction involves 90 degree flexion at MCP
joint, 90 degree flexion at PIP joint, pressure as shown
below:
Pain control
Orthopedic referral
8. Duke orthopedics- online
Pocket Radiologist- ER Trauma
Emergency Orthopedics – The extremities. Robert R. Simon