Patient reported outcome of fifth metacarpal neck fracture treated with buddy taping vs ulnar gutter cast.
Background: Buddy taping (BT) and ulnar gutter cast (UGC) are commonly used for treatment of fractures of the neck of the 5th Metacarpal. This retrospective analysis aims to investigate if UGC is a superior treatment option regarding symptom improvement as reported by the patient using the shortened Disability of Arm, Shoulder and Hand (QuickDASH®) score. Methods: Forty-eight patients with uncomplicated fractures of the neck of the 5th metacarpal presented to our unit from July 2017 to June 2019. Patients received either BT or UGC depending on the treating surgeon. They filled out the QuickDASH® on presentation and only 39 returned a follow-up questionnaire in September 2019. A retrospective analysis of QuickDASH® scores at presentation and follow-up was conducted and the change to the score was recorded for each patient as the clinical difference (CD). Patients were stratified in two Groups according to their management. The primary outcome is to measure the CD against the minimally clinical important difference (MCID). Results: Twenty patients received BT and 19 had UGC. Both groups were normally distributed. No statistical difference was observed in the change between the initial and follow-up QuickDASH® scores between both cohorts. A significant positive correlation was found between both the initial QuickDASH® and the clinical difference (CD) and the follow up QuickDASH® and the Dorsal Apex Angle (DAA) (p <0.001. Conclusion: The patient-reported outcomes show no significant difference between BT and UGC in treating 5th metacarpal neck fractures. However, BT may require fewer resources and fewer follow-up appointments, ultimately reducing the cost of treatment in a pressured health care service.
Keywords: 5th Metacarpal neck fractures, Buddy tapping, patient reported outcomes.
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