Point-of-Care Ultrasound for Guidance of Closed Reduction of Fifth Metacarpal Neck (Boxer's) Fracture



      Ultrasound has been previously utilized in fracture identification, analgesia delivery, and fracture reduction in Emergency Department patients. 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 male 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 subsequent hand x-ray. Following 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 confirmed improved angulation and adequate alignment
      Why should an emergency physician be aware of this? Point of care ultrasound has previously shown efficacy in fracture diagnosis and anesthesia delivery for fifth metacarpal fractures. Ultrasound can also be employed at the bedside to assist in the determination of adequate fracture reduction when performing closed reduction of a Boxer's fracture
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