Abstract
Background
Ultrasound has been used previously in fracture identification, analgesia delivery,
and fracture reduction for patients in the emergency department. It has not been previously
described as a tool for the guidance of closed fracture reduction in fifth metacarpal
neck fractures (“boxer's fractures").
Case Report
A 28-year-old man presented with hand pain and swelling after punching a wall. Point-of-care
ultrasound revealed a significantly angulated fifth metacarpal fracture, which was
confirmed with a subsequent hand x-ray study. After an ultrasound-guided ulnar nerve
block, closed reduction was performed. Ultrasound was used to assess reduction and
ensure improvement in bony angulation during the closed reduction attempts. Post-reduction
x-ray study confirmed improved angulation and adequate alignment. Why Should an Emergency
Physician Be Aware of This? Point-of-care ultrasound has previously had efficacy in
fracture diagnosis and anesthesia delivery for fifth metacarpal fractures. Ultrasound
can also be used at the bedside to assist in the determination of adequate fracture
reduction when performing closed reduction of a boxer's fracture.
Keywords
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Article info
Publication history
Published online: January 16, 2023
Accepted:
January 6,
2023
Received in revised form:
December 23,
2022
Received:
August 16,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
