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Archives of Orthopaedic and Trauma Surgery

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01-01-2016 | Handsurgery

Fifth metacarpal neck fractures treated with soft wrap/buddy taping compared to reduction and casting: results of a prospective, multicenter, randomized trial

Authors: Jan van Aaken, Cesare Fusetti, Stefano Luchina, Stefania Brunetti, Jean-Yves Beaulieu, Angèle Gayet-Ageron, Kathryn Hanna, Alexander Y. Shin, Eric Hofmeister

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2016

Abstract

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.

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Title: Fifth metacarpal neck fractures treated with soft wrap/buddy taping compared to reduction and casting: results of a prospective, multicenter, randomized trial
Authors: Jan van Aaken
Cesare Fusetti
Stefano Luchina
Stefania Brunetti
Jean-Yves Beaulieu
Angèle Gayet-Ageron
Kathryn Hanna
Alexander Y. Shin
Eric Hofmeister
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2361-0

At a glance: The STEP trials

Springer Medicine

Fifth metacarpal neck fractures treated with soft wrap/buddy taping compared to reduction and casting: results of a prospective, multicenter, randomized trial

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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