TY - JOUR
T1 - Fifth metacarpal neck fractures treated with soft wrap/buddy taping compared to reduction and casting
T2 - results of a prospective, multicenter, randomized trial
AU - van Aaken, Jan
AU - Fusetti, Cesare
AU - Luchina, Stefano
AU - Brunetti, Stefania
AU - Beaulieu, Jean Yves
AU - Gayet-Ageron, Angèle
AU - Hanna, Kathryn
AU - Shin, Alexander Y.
AU - Hofmeister, Eric
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Introduction: The majority of fifth metacarpal neck fractures (boxers fracture) are treated conservatively without surgery. The purpose of this prospective, randomized, multicenter trial was to determine if the outcomes of soft wrap and buddy taping (SW) was noninferior to reduction and cast (RC) in boxer’s fracture with palmar angulation ≤70° and no rotational deformity. Materials and methods: Sixty-eight patients with similar characteristics were prospectively enrolled and randomized at four institutions. Our primary outcome was measured by the shortened Disabilities of the Arm, Shoulder and Hand (quickDASH) questionnaire at 4 months. Noninferiority was claimed if there was no more than +10 points difference in the quickDASH. Other secondary radiographic and clinical outcomes were measured. Results: At 4 months, mean difference in the quickDASH between the two groups was −10.4 (95 % confidence interval, −27.0; +6.2) which was under the pre-specified margin. There was no significant difference between both groups’ secondary outcomes of pain, satisfaction with the esthetic appearance, mobility of the metacarpophalangeal-joint at flexion and extension, or power grip. Increased fracture angulation, as measured on follow-up radiographs, was not significantly different between both groups. The degree of palmar fracture angulation was not related to work leave or profession. Duration of time off from work was 11 days shorter in SW compared to RC (P = 0.03). Conclusion: This study supports the use of soft wrap and buddy taping for treatment of boxer’s fracture with palmar angulation ≤70° and no rotational deformity. Although there was no statistical difference in satisfaction with the esthetic appearance, the patient must be willing to accept the loss of the “knuckle” with this treatment method.
AB - Introduction: The majority of fifth metacarpal neck fractures (boxers fracture) are treated conservatively without surgery. The purpose of this prospective, randomized, multicenter trial was to determine if the outcomes of soft wrap and buddy taping (SW) was noninferior to reduction and cast (RC) in boxer’s fracture with palmar angulation ≤70° and no rotational deformity. Materials and methods: Sixty-eight patients with similar characteristics were prospectively enrolled and randomized at four institutions. Our primary outcome was measured by the shortened Disabilities of the Arm, Shoulder and Hand (quickDASH) questionnaire at 4 months. Noninferiority was claimed if there was no more than +10 points difference in the quickDASH. Other secondary radiographic and clinical outcomes were measured. Results: At 4 months, mean difference in the quickDASH between the two groups was −10.4 (95 % confidence interval, −27.0; +6.2) which was under the pre-specified margin. There was no significant difference between both groups’ secondary outcomes of pain, satisfaction with the esthetic appearance, mobility of the metacarpophalangeal-joint at flexion and extension, or power grip. Increased fracture angulation, as measured on follow-up radiographs, was not significantly different between both groups. The degree of palmar fracture angulation was not related to work leave or profession. Duration of time off from work was 11 days shorter in SW compared to RC (P = 0.03). Conclusion: This study supports the use of soft wrap and buddy taping for treatment of boxer’s fracture with palmar angulation ≤70° and no rotational deformity. Although there was no statistical difference in satisfaction with the esthetic appearance, the patient must be willing to accept the loss of the “knuckle” with this treatment method.
KW - 5th metacarpal neck fracture
KW - Boxer’s fracture
KW - Cast
KW - Prospective
KW - Randomized
KW - Soft dressing
KW - Treatment
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U2 - 10.1007/s00402-015-2361-0
DO - 10.1007/s00402-015-2361-0
M3 - Article
C2 - 26559192
AN - SCOPUS:84953637977
SN - 0936-8051
VL - 136
SP - 135
EP - 142
JO - Archives of Orthopaedic and Trauma Surgery
JF - Archives of Orthopaedic and Trauma Surgery
IS - 1
ER -