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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 211 - 211
1 Sep 2012
Barlow D O'hagan E Sanathkumar S Gull A Balasundaram R
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Background

Boxer's fractures are the most common type of metacarpal fracture. It commonly occurs during fistfights or from punching a wall. Greer et al demonstrated that it is usually an intentional injury and these patients were at increased risk for recurrent injury (2). Further work suggested that patients with such injuries had higher features of antisocial, self- harm and impulsive behavior, compared with control groups (3).

There is little that has been reported on children and adolescents who present with such fractures.

This study aims to assess aggression scores in young patients with metacarpal fractures due to punching using a validated questionnaire.

Methodology

Following ethical permission, 11–18 year olds, with a boxers fracture and willing to complete an anonymous questionnaire were included. If they were under 16, parental permission was sought. The Buss and Warren validated questionnaire included subscales of physical aggression and anger scales as well as overall aggression scoring.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XVII | Pages 43 - 43
1 May 2012
Barlow D O'Hagan L Gull A Shetty S Ramesh B
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Background

Isolated fractures of the distal fourth or fifth metacarpal bones, known as boxer's fractures (BF), are the most common type of metacarpal fracture. Boxer's fractures received their name from one of their most common causes — punching an object with a closed fist. This injury has been described as “a tolerable fracture in an intolerable patient” (1) It occurs commonly during fistfights or from punching a hard object such as a wall. Greer and William demonstrated that it is usually an intentional injury and these patients were at increased risk for recurrent injury (2). Further work suggested that patients with such injuries had higher features of antisocial, self-defeating personality disorders, self harm and impulsive behaviour, compared with control groups (3). It has been suggested that all patients presenting with such an injury should have psychiatric assessment.

The majority of studies in the literature have concentrated on adults and little has been reported on children and adolescents who present with such fractures.

This study aims to assess aggression scores in young patients discharged with metacarpal fractures due to punching using a validated questionnaire and this abstract presents the interim analysis.

Methodology

Following ethical permissions patients between 11 and 18 years of age, discharged with a metacarpal fracture caused by punching diagnosis codes S622, S623 or S624 and willing to complete an anonymous quetionnairre were included. All patients recieved an information sheet and for young people under 16 parental permission was sought.

The Bus and Warren validated questionnaire was completed by post, in person or over the telephone. The questionnaire included subscales of physical aggression and anger scales as well as overall aggression scoring and patients were asked to complete all sections.