Nonsurgical Treatment of Fifth Metacarpal Neck Fractures

The Journal of hand surgery (Impact Factor: 1.67). 04/2009; 34(3):578; author reply 578-9. DOI: 10.1016/j.jhsa.2008.12.013
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    ABSTRACT: The ideal treatment for a boxer's fracture remains controversial, particularly the degree of volar dislocation considered acceptable for nonoperative treatment. From December 2003 to December 2004, 25 patients who sustained a subcapital metacarpal fracture of the little finger with volar angulation between 30 to 75 degrees were prospectively enrolled in the study. All patients were treated with a circular self-adherent wrap covering metacarpal bones II-V and buddy taping of the ring and little fingers for a period of 3 weeks while allowing immediate free range of motion. Final evaluation at a mean of 5 months revealed all patients to be satisfied without subjective functional impairment. All fractures healed, and the angulation of the fracture remained unchanged, but moderate shortening was observed. Active flexion of the metacarpophalangeal (MCP) joint was significantly lower on the fracture side, but as the median degree of MCP flexion was the same, this statistical difference was without clinical relevance. There was no loss in grip strength. A subjective long-term evaluation was performed by phone; at a median of 3 years, a QuickDash score gave a median of 0 point. Treating a boxer's fracture with angulation of up to 75 degrees by soft wrap and buddy taping resulted in satisfied patients and good clinical results.
    Hand 01/2008; 2(4):212-7. DOI:10.1007/s11552-007-9054-2