RT3-AM articles and summary

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

Summary of articles

  • This is a prospective randomized control trial
  • Purpose of this study: To determine if the outcomes of soft wrap and buddy taping is not inferior to reduction and cast in boxer’s fracture
  • Method: 68 patients with fifth metacarpal neck fracture
  • Soft wrap and buddy taping group: 37 patients. The little finger is buddy taped to the ring finger using Velcro straps. The wrist and palmar remain free of the wrap.
  • Reduction and cast group: 27 patients. Reduction is performed using hematoma block of 5ml 1% lidocaine, then longitudinal traction is applied for 10 min on the pinky and ring fingers. Then a cast is applied and extended to PIP joint and immobilized metacarpophalangeal joint.
  • Outcomes

Both groups are followed up for 4 months

Primary outcomes: use shortened Disabilities of the Arm, Shoulder and Hand (quickDASH) questionnaire score

Secondary outcomes: assess pain on a visual analog scale of pain; duration of absence from work, range of motion

  • Results:

No statistical difference between these two groups in quickDASH at 4 months.

No statistical difference between these two groups regarding pain, or range of motion.

  • Conclusion

These findings indicate that soft wrap treatment is not inferior to reduction and cast treatment in patient with boxer fracture at 4 months follow up.

  • Relating to my patient

My patient, Mr. C is 28 years old male, who gets involved in a flight presents to urgent care with boxer fracture. We apply ulnar gutter splint and ask patient to follow up with ortho to get cast. The patient is a lawyer, cast is inconvenient for him to runs his office. If soft wrap is noninferior to reduction and cast, he prefers soft wrap. However, there are some limitations for this study. Sample size is small, and follow up time is short. Further study and research will be needed to explore efficacy of soft wrap vs. reduction and cast.

 

fifth metacarpal neck fractures treated with soft wrap buddy taping compared to reduction and casting RCT

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