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Erschienen in: HAND 4/2015

01.12.2015

Satisfaction and functional outcome with “self-care” for the management of fifth metacarpal fractures

verfasst von: David Gamble, Paul J. Jenkins, Martyn J. Edge, Alisdair Gilmour, Iain C. Anthony, Margaret Nugent, Lech A. Rymaszewski

Erschienen in: HAND | Ausgabe 4/2015

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Abstract

Background

Fifth metacarpal fractures are common and comprise a significant proportion of traditional orthopaedic fracture clinic workload. We reviewed the functional outcome and the satisfaction of patients managed with a new protocol that promoted “self-care” and resulted in the discharge of most of these patients from the emergency department with no further follow-up.

Methods

A retrospective study was performed of patients discharged with a fifth metacarpal fracture between April 2012 to October 2012. A postal questionnaire was sent to each patient, followed by a telephone call. Patient-reported outcome measures (EQ-5D, QuickDASH) and patient satisfaction were assessed. Of the 167 patients eligible for the study, 5 were excluded. Of the remaining 162, 64 were uncontactable or declined to participate. The mean follow-up time was 21.6 months (SD 1.9, range 18.1 to 24.7).

Results

The median EQ-5D health index score was 0.87 (IQR 0.74 to 1.00), and the median QuickDASH score was 2.3 (IQR 0 to 6.8). Seventy-nine (80.6 %) patients were satisfied with the outcome of their injury, while 83 (84.9 %) reported being satisfied with the process. There was no difference between those with a fracture or those without a fracture in EQ-5D (p = 0.307) or QuickDASH (p = 0.820).

Conclusion

Fifth metacarpal fractures can be managed effectively through an Emergency Department protocol without any formal orthopaedic follow-up. This pathway lead to excellent patient-reported outcome measures and patient satisfaction. This protocol has reduced unnecessary hospital attendances for patients and increased the time available for clinicians to deal with more challenging injuries.
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Metadaten
Titel
Satisfaction and functional outcome with “self-care” for the management of fifth metacarpal fractures
verfasst von
David Gamble
Paul J. Jenkins
Martyn J. Edge
Alisdair Gilmour
Iain C. Anthony
Margaret Nugent
Lech A. Rymaszewski
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
HAND / Ausgabe 4/2015
Print ISSN: 1558-9447
Elektronische ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-015-9749-8

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