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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-12

AUTHORS

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

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. More... »

PAGES

607-612

Journal

TITLE

HAND

ISSUE

4

VOLUME

10

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11552-015-9749-8

DOI

http://dx.doi.org/10.1007/s11552-015-9749-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052934344

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26568712


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