Boxers Fracture - How Ironic.!!
Discussion
I've just got back from my local hospital and was told after an x-ray that I have a 'boxer's fracture' - broken 5th metacarpal.
Ironically, I haven't punched anything or anyone in my life (except when I was 6 and thought I was Bruce Lee)!!
They looked a bit cynical when I told them I fell on the ice outside my house whilst walking my 3 dogs (have they not seen the weather recently)??
Anyway, I have to go to see a specialist on Friday and the woman I saw today said they may need to operate.
Does anyone have any experience with this and would any such operation be done with local or general anaesthetic?
I've not had an operation before
Ironically, I haven't punched anything or anyone in my life (except when I was 6 and thought I was Bruce Lee)!!
They looked a bit cynical when I told them I fell on the ice outside my house whilst walking my 3 dogs (have they not seen the weather recently)??
Anyway, I have to go to see a specialist on Friday and the woman I saw today said they may need to operate.
Does anyone have any experience with this and would any such operation be done with local or general anaesthetic?
I've not had an operation before
From what I can see, use of general anaesthetic is really counter-intuitive.
I've had three operations in the last couple of years. One for dental treatment accessing the tooth root from the top via the jaw rather than through the tooth itself, another was keyhole surgery on a ganglion on my wrist and the last was to have a finger broken in 3 places pinned back together again.
I wasn't surprised to be told that the dental one would be done under general, but I was fully expecting the other two to be under local, and was amazed to find out they would also be done under general, especially after a former neighbour had a cataract removed under local!
On asking the surgeon how come they'd happily jab scalpels in someone's eye under local but needed a general to fiddle around with my little finger, I was told it was because there was a greater chance of an involuntary muscle spasm in the hand at just the wrong time if done under local or some such. Whether this is true or just the surgeon's version of "delayed due to signalling problems", I don't know.
I've had three operations in the last couple of years. One for dental treatment accessing the tooth root from the top via the jaw rather than through the tooth itself, another was keyhole surgery on a ganglion on my wrist and the last was to have a finger broken in 3 places pinned back together again.
I wasn't surprised to be told that the dental one would be done under general, but I was fully expecting the other two to be under local, and was amazed to find out they would also be done under general, especially after a former neighbour had a cataract removed under local!
On asking the surgeon how come they'd happily jab scalpels in someone's eye under local but needed a general to fiddle around with my little finger, I was told it was because there was a greater chance of an involuntary muscle spasm in the hand at just the wrong time if done under local or some such. Whether this is true or just the surgeon's version of "delayed due to signalling problems", I don't know.
There is no irony here.
It might have been considered ironic if, for example, you were an ex boxer who had never in his entire career broken anything, and had slipped and caused the damage at an anti-boxing rally, while attempting to stop someone else getting punched.
As it is, not so much.
It might have been considered ironic if, for example, you were an ex boxer who had never in his entire career broken anything, and had slipped and caused the damage at an anti-boxing rally, while attempting to stop someone else getting punched.
As it is, not so much.
I broke my little finger a few years ago. Fell onto my hand at a funny angle playing football (badly).
I was told it needed pinning and immediately i shat myself having never had a general anaesthetic before.
When the anaesthetist came round to see me (as they do before an op) i asked about the possibility of a local. He said that they wouldn't normally consider it unless i had a cold or other problem that effected my respiratory system. I let out a somewhat pathetic cough and said i had a bit of a cold. It was enough for them to do the op under a local!!
Just so you know. They inject the local anaesthetic into your arm pit. It fooking hurts!!! Made my eyes water (Not crying!!!!!) but the comedy effect of having a totally dead arm is worth it!! Careful not to smack yourself in the face when showing people where the needle went though. I did it twice!!!
I was told it needed pinning and immediately i shat myself having never had a general anaesthetic before.
When the anaesthetist came round to see me (as they do before an op) i asked about the possibility of a local. He said that they wouldn't normally consider it unless i had a cold or other problem that effected my respiratory system. I let out a somewhat pathetic cough and said i had a bit of a cold. It was enough for them to do the op under a local!!
Just so you know. They inject the local anaesthetic into your arm pit. It fooking hurts!!! Made my eyes water (Not crying!!!!!) but the comedy effect of having a totally dead arm is worth it!! Careful not to smack yourself in the face when showing people where the needle went though. I did it twice!!!
I suffered a boxer's fracture last year in a motorcycle accident:
You can't see it in that x-ray, but the latter ones did, the bone was actually shattered into seven pieces, about half the shaft, the knuckle at the end and five fragments between
After the initial A&E stuff I saw the fracture clinic consultant on a Monday, the little finger was rotated meaning corrective surgery was needed, they said they'd call in the next few days. Tuesday I get a call and go into surgery, they inserted a K-wire from the wrist to the 2nd joint past the break. Surgery was general anaesthetic but I was able to go home that evening, on a combination on Tramadol, Paracetamol and Volterol
Hand was in a cast from forearm to fingers for ~6 weeks, wire removed at 4 weeks. Afterwards movement was quite limited but over a few weeks full movement returned, little finger is still slightly rotated but only affects me when playing the guitar as it lands in a slightly different place than I'm used to, everything else is 100% normal. No after effects apart from a bit of pain and stiffness in very cold weather
You can't see it in that x-ray, but the latter ones did, the bone was actually shattered into seven pieces, about half the shaft, the knuckle at the end and five fragments between
After the initial A&E stuff I saw the fracture clinic consultant on a Monday, the little finger was rotated meaning corrective surgery was needed, they said they'd call in the next few days. Tuesday I get a call and go into surgery, they inserted a K-wire from the wrist to the 2nd joint past the break. Surgery was general anaesthetic but I was able to go home that evening, on a combination on Tramadol, Paracetamol and Volterol
Hand was in a cast from forearm to fingers for ~6 weeks, wire removed at 4 weeks. Afterwards movement was quite limited but over a few weeks full movement returned, little finger is still slightly rotated but only affects me when playing the guitar as it lands in a slightly different place than I'm used to, everything else is 100% normal. No after effects apart from a bit of pain and stiffness in very cold weather
Thanks for the info guys - I'm really s
tting myself now
My little finger doesn't look twisted, but I can't lift it up to its usual position, so I'm assuming they will need to go in.
I guess I won't have surgery on Friday then as the trauma clinic haven't seen me yet - just my local community hospital for x-rays.
I presume they give you a bit of notice before you have to go in and what to expect?
tting myself now My little finger doesn't look twisted, but I can't lift it up to its usual position, so I'm assuming they will need to go in.
I guess I won't have surgery on Friday then as the trauma clinic haven't seen me yet - just my local community hospital for x-rays.
I presume they give you a bit of notice before you have to go in and what to expect?
the_lone_wolf said:
After the initial A&E stuff I saw the fracture clinic consultant on a Monday, the little finger was rotated meaning corrective surgery was needed, they said they'd call in the next few days. Tuesday I get a call and go into surgery, they inserted a K-wire from the wrist to the 2nd joint past the break. Surgery was general anaesthetic but I was able to go home that evening, on a combination on Tramadol, Paracetamol and Volterol
Hand was in a cast from forearm to fingers for ~6 weeks, wire removed at 4 weeks. Afterwards movement was quite limited but over a few weeks full movement returned, little finger is still slightly rotated but only affects me when playing the guitar as it lands in a slightly different place than I'm used to, everything else is 100% normal. No after effects apart from a bit of pain and stiffness in very cold weather
Sounds identical to my experience, I had the K wire in and the hand was bandaged with the little finger strapped to the next one. The following week I managed to fit a towbar to my Impreza with it still in. The only issues I had were that the end of the wire caught in the bandage every time I moved my wrist, which smarted a touch. I was amazed when the Doc removed it with pliers and no anaesthetic and saw the little hole that was left, but it didn't hurt. Now I just have a lump where the break was, my little finger is twisted somewhat and the cold makes it ache.Hand was in a cast from forearm to fingers for ~6 weeks, wire removed at 4 weeks. Afterwards movement was quite limited but over a few weeks full movement returned, little finger is still slightly rotated but only affects me when playing the guitar as it lands in a slightly different place than I'm used to, everything else is 100% normal. No after effects apart from a bit of pain and stiffness in very cold weather
They don't normally operate on a boxers fracture unless the knuckle part (your metacarpal head) is more than 45 degrees to your metacarpal or your finger is rotated (noted by folding your fingers into your palm - they shouldn't overlap each other and should all point in the same direction).
If they do operate - is normally done under general anaesthetic with Kwires, as previously mentioned.
If they do operate - is normally done under general anaesthetic with Kwires, as previously mentioned.
Little Nicky said:
Thanks for the info guys - I'm really stting myself now
My little finger doesn't look twisted, but I can't lift it up to its usual position, so I'm assuming they will need to go in.
I guess I won't have surgery on Friday then as the trauma clinic haven't seen me yet - just my local community hospital for x-rays.
I presume they give you a bit of notice before you have to go in and what to expect?
Don't worry about it, surgery is nothing, seriouslytting myself now My little finger doesn't look twisted, but I can't lift it up to its usual position, so I'm assuming they will need to go in.
I guess I won't have surgery on Friday then as the trauma clinic haven't seen me yet - just my local community hospital for x-rays.
I presume they give you a bit of notice before you have to go in and what to expect?
If the finger isn't rotated you may not require surgery anyway, the consultant who first saw me ummed and ahhed over whether or not to operate and eventually said it was up to me, if I was happy with the slight bend he could leave it or if I wanted it fixed could have it done, I opted to get it fixed properly and I've no regrets with doing so
When you visit the fracture clinic the consultant will see you and discuss the options available, he can't force you to do anything but remember he's the expert and it's probably wise to listen carefully to what he's saying. I found taking a second person with you enables you to remember more about the talk than if you were on your own and a little overwhelmed (my mum was diagnosed with breast cancer the year before last and it was invaluable having a second set of ears when talking to the docs/surgeons)
If you decide to operate they'll want to get it done ASAP, the bone is healing right now and if it's twisted it's not healing correctly. I was told on the Monday morning I'd be called sometime that week. On the Tuesday I had a call at 09:15 asking me if I could be there by 10:00
Don't sweat the possibility of surgery dude, it really isn't a bad thing, just like going to sleep. The only bad bit is the first few hours after they wake you up as you feel like death and your hand will hurt like hell even though you're doped up to the nines on morphine and others, but compared to the benefits of getting your finger sorted properly it's insignificant.
Dover Nige said:
Sounds identical to my experience, I had the K wire in and the hand was bandaged with the little finger strapped to the next one. The following week I managed to fit a towbar to my Impreza with it still in. The only issues I had were that the end of the wire caught in the bandage every time I moved my wrist, which smarted a touch. I was amazed when the Doc removed it with pliers and no anaesthetic and saw the little hole that was left, but it didn't hurt. Now I just have a lump where the break was, my little finger is twisted somewhat and the cold makes it ache.
Yep, I experienced everything you mentioned there, although in my case it wasn't fitting a towbar but piloting a canal boat in the south of France!! even in my emergency plaster I got from A&E I removed the bike from the trailer once we got home and swapped the exhaust back to the stock one and removed the little accessories that the insurers wouldn't replace
The pliers were hilarious, I had a handful of appointments at the fracture clinic so got to know the nurses there quite well, we always had a laugh and a joke but the B&Q pliers were awesome, amazed how after the jip the wire gave me on the plaster how it didn't hurt when he just ripped five inches of tent peg out my hand!!!the_lone_wolf said:
Little Nicky said:
Thanks for the info guys - I'm really stting myself now
My little finger doesn't look twisted, but I can't lift it up to its usual position, so I'm assuming they will need to go in.
I guess I won't have surgery on Friday then as the trauma clinic haven't seen me yet - just my local community hospital for x-rays.
I presume they give you a bit of notice before you have to go in and what to expect?
Don't worry about it, surgery is nothing, seriouslytting myself now My little finger doesn't look twisted, but I can't lift it up to its usual position, so I'm assuming they will need to go in.
I guess I won't have surgery on Friday then as the trauma clinic haven't seen me yet - just my local community hospital for x-rays.
I presume they give you a bit of notice before you have to go in and what to expect?
If the finger isn't rotated you may not require surgery anyway, the consultant who first saw me ummed and ahhed over whether or not to operate and eventually said it was up to me, if I was happy with the slight bend he could leave it or if I wanted it fixed could have it done, I opted to get it fixed properly and I've no regrets with doing so
When you visit the fracture clinic the consultant will see you and discuss the options available, he can't force you to do anything but remember he's the expert and it's probably wise to listen carefully to what he's saying. I found taking a second person with you enables you to remember more about the talk than if you were on your own and a little overwhelmed (my mum was diagnosed with breast cancer the year before last and it was invaluable having a second set of ears when talking to the docs/surgeons)
If you decide to operate they'll want to get it done ASAP, the bone is healing right now and if it's twisted it's not healing correctly. I was told on the Monday morning I'd be called sometime that week. On the Tuesday I had a call at 09:15 asking me if I could be there by 10:00
Don't sweat the possibility of surgery dude, it really isn't a bad thing, just like going to sleep. The only bad bit is the first few hours after they wake you up as you feel like death and your hand will hurt like hell even though you're doped up to the nines on morphine and others, but compared to the benefits of getting your finger sorted properly it's insignificant.
Dover Nige said:
Sounds identical to my experience, I had the K wire in and the hand was bandaged with the little finger strapped to the next one. The following week I managed to fit a towbar to my Impreza with it still in. The only issues I had were that the end of the wire caught in the bandage every time I moved my wrist, which smarted a touch. I was amazed when the Doc removed it with pliers and no anaesthetic and saw the little hole that was left, but it didn't hurt. Now I just have a lump where the break was, my little finger is twisted somewhat and the cold makes it ache.
Yep, I experienced everything you mentioned there, although in my case it wasn't fitting a towbar but piloting a canal boat in the south of France!! even in my emergency plaster I got from A&E I removed the bike from the trailer once we got home and swapped the exhaust back to the stock one and removed the little accessories that the insurers wouldn't replace The pliers were hilarious, I had a handful of appointments at the fracture clinic so got to know the nurses there quite well, we always had a laugh and a joke but the B&Q pliers were awesome, amazed how after the jip the wire gave me on the plaster how it didn't hurt when he just ripped five inches of tent peg out my hand!!!I feel a bit better about things now.
Cheers all.
Nick
Little Nicky said:
the_lone_wolf said:
...let us know how it works out...
Will do mate.PS. How did you get an electronic copy of your x-ray? It would be really cool if I could upload mine for a comparison...
Look closely at the top left corner and you'll see my thumb..
I had the accident in Shropshire but live down south, they gave me the X-Ray and my paperwork to take back to my local A&E the next day
They don't seem keen to hand them out unless there's a genuine medical reason
the_lone_wolf said:
Little Nicky said:
the_lone_wolf said:
...let us know how it works out...
Will do mate.PS. How did you get an electronic copy of your x-ray? It would be really cool if I could upload mine for a comparison...
Look closely at the top left corner and you'll see my thumb..
I had the accident in Shropshire but live down south, they gave me the X-Ray and my paperwork to take back to my local A&E the next day
They don't seem keen to hand them out unless there's a genuine medical reason
most trusts haven't the money to print out patient copies of xrays
digital export is only possible on certain computers in certain trusts, and breaks IT security rules
---> Take a camera and photograph the xray picture in a horible digital-to-analogue bast&rdisation..
that's what I tell my patients to do
and it's usually >60degrees angulation for a "Boxer's" fracture before surgery, that or mal-rotation, open fracture, severe extensor lag, neurological injury, concommitant other m/c neck farctures, etc
The "Boxer's" nomenclature is the description of the type of fracture, not the suspected method that you did it. Although I have probably seen about 6.42zillion people with that break from drunken fights..
the_lone_wolf said:
I suffered a boxer's fracture last year in a motorcycle accident:
nicely done, here's mine
only i got mine the
anyways they offered me an operation after id had a cast on for a while saying my knuckle might stay a bit sunken. they also warned me that when they cut my hand open and re-break my finger there's a chance i could lose mobility in the finger. so the choice was looks or function. if this is your choice im happy to report i've got all 10 digits working fine, just one of them is a bit wonky
ETA
The_Doc said:
---> Take a camera and photograph the xray picture in a horible digital-to-analogue bast&rdisation..
that is uncanny as its exactly what i did.as you may notice i took a photo of the computer screen using my phone, then had to take a picture of my phone using my camera to upload it here [/bast&rdisation]
Edited by samdale on Monday 11th January 16:25
Hi guys - sorry for the delay in my progress update...
Due to the weather, I was told that my appointment to decide whether I would need an operation was to be cancelled as they were only open to emergency cases.!!
I asked where that left me and my broken 5th M'carpal and they said to keep it strapped up for 6 weeks and if I have any problems then get back in touch with them.
I've done that and I'm not in any pain (unless I knock it or put any strain on my hand) but I wasn't massively impressed with the service I got.
They basically said if there was a problem after 6 weeks, I may need it re-broken and pinned - setting me back another 6 weeks I guess.
I'm hoping it's OK when It's done healing (crosses the fingers I can still cross).
I snuck a preview at the notes I got from the community hospital that did my x-ray and it says that I've fractured the neck of my m/c - not sure whether that's reletively good / bad?
The swelling has pretty much gone now and I can see a "manly" lump in the bone where the fracture is - here's hoping it sorts itself out, and I'm secretly happy that I've not had to go through the surgery - although I guess that's still not been ruled out for the future.
Due to the weather, I was told that my appointment to decide whether I would need an operation was to be cancelled as they were only open to emergency cases.!!
I asked where that left me and my broken 5th M'carpal and they said to keep it strapped up for 6 weeks and if I have any problems then get back in touch with them.
I've done that and I'm not in any pain (unless I knock it or put any strain on my hand) but I wasn't massively impressed with the service I got.
They basically said if there was a problem after 6 weeks, I may need it re-broken and pinned - setting me back another 6 weeks I guess.
I'm hoping it's OK when It's done healing (crosses the fingers I can still cross).
I snuck a preview at the notes I got from the community hospital that did my x-ray and it says that I've fractured the neck of my m/c - not sure whether that's reletively good / bad?
The swelling has pretty much gone now and I can see a "manly" lump in the bone where the fracture is - here's hoping it sorts itself out, and I'm secretly happy that I've not had to go through the surgery - although I guess that's still not been ruled out for the future.
Any update on this?
Sounds like the NHS aren't being as good with you as they were with me!!
Sounds like the NHS aren't being as good with you as they were with me!!
Little Nicky said:
I snuck a preview at the notes I got from the community hospital that did my x-ray and it says that I've fractured the neck of my m/c - not sure whether that's reletively good / bad?
The neck of the bone is the part just below the wider ends, I think it's by far the most common place to crack the pinkie bone during a boxer's fractureGassing Station | Health Matters | Top of Page | What's New | My Stuff