The relationship between impulsivity and anxiety and recurrent metacarpal fractures due to punch injury

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ORIGINAL PAPER

The relationship between impulsivity and anxiety and recurrent metacarpal fractures due to punch injury Altuğ Duramaz 1

&

Alican Koluman 1

&

Altan Duramaz 2

&

Cemal Kural 1

Received: 22 May 2020 / Revised: 27 August 2020 / Accepted: 1 September 2020 # SICOT aisbl 2020

Abstract Purpose The study aimed to determine the relationship between impulsivity and anxiety and recurrent metacarpal fractures (RMF) due to punching injury. Methods Consecutive 368 patients (301 men and 67 women) with metacarpal fracture who met the inclusion criteria and 214 healthy controls were included in the study. The study group was divided into two as the first metacarpal fracture (FMF) (245 patients) and RMF (123 patients). The control group consisted of sex- and age-matched 214 healthy participants (175 men and 39 women). Beck anxiety inventory (BAI), Barratt impulsiveness scale (BIS 11), and Quick DASH scores were the assessment of the patients in the sixth month of treatment. The groups were compared in terms of demographic features (including education status, marital status, work status, and level of income), fracture side, fracture location, dominant hand, treatment, anxiety, impulsivity, and functional results. Results In the RMF, BIS 11, BAI, and Quick DASH scores were significantly higher than the FMF and the healthy controls (p = 0.001 and p = 0.001, respectively). The patients with RMF have higher impulsivity and anxiety, worse short-term functional outcomes, and lower level of income and education status compared with healthy controls and FMF. Conclusion Anxiety and impulsivity are higher in patients with RMF. It adversely affects the clinical outcome after the treatment. Psychiatric consultation is an important step for especially intentional RMF patients to prevent recurrent hand injuries and metacarpal fractures and to improve clinical outcomes associated with these injuries. Keywords Metacarpal fractures . Injury recidivism . Impulsive behaviour . Anxiety disorders . Intentional punching injury

Level of Evidence: Level II, prospective study The study entitled ‘The relationship between impulsivity and anxiety and recurrent metacarpal fractures due to punch injury’ was performed in Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey. * Altuğ Duramaz [email protected] Alican Koluman [email protected] Altan Duramaz [email protected] Cemal Kural [email protected] 1

Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147 Bakırköy, Istanbul, Turkey

2

Republic of Turkey Ministry of National Education, Şehit Mehmet Öter Street, Number 1, 27090 Şehitkamil, Gaziantep, Turkey

Introduction Hand injuries compose for approximately a quarter of all musculoskeletal injuries seen in emergency departments [1]. Most of these injuries are metacarpal and phalanx fractures. The most common types of metacarpal fractures are the fourth and the fifth