The BREACH

Boxer's fracture: does it really need a plaster cast?


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Background: One fifth of hand injuries are fifth metacarpal neck fractures ('boxer's fractures'). If stable, these are traditionally treated with an ulnar gutter back slab in the first instance. Several trials have looked at buddy strapping as an alternative, but in 2005 a Cochrane review​1​ concluded that existing studies were underpowered to detect a difference in functional outcomes. Since that time, however, at least 3 trials​2–4​ have been published, each coming to the same conclusion. Here we take a look at the most recent one, which is currently only available online (it hasn't been published in written form yet).
 
 Pellatt R, Fomin I, Pienaar C, Bindra R, Thomas M, Tan E, et al. Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? A Randomized Controlled Trial. Annals of Emergency Medicine. 2019 March​4​
 
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The BREACHBy Barrie Stevenson