Outcome of boxer's fractures treated by a soft wrap and buddy taping: a prospective study

Abstract

Introduction: The ideal treatment for a boxer's fracture remains controversial, particularly the degree of volar dislocation considered acceptable for nonoperative treatment.

Patients and methods: 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.

Results: 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.

Conclusion: 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.

Figure 1

Fracture treatment with self-adherent wrap and strapping of the fourth and fifth fingers.

Figure 2

The figure shows initial, contralateral, and final (2-month) radiographies. Shortening was measured by the distance between tangential lines to the fourth and fifth metacarpal heads compared to the contralateral hand; in this case, 5.5–2.9 mm = 2.6 mm for initial and final shortening. Angulation was measured on 45° oblique radiographies; in this case, 55° on initial and final evaluation.