Which statement is true about Boxer's fracture management?

Which statement is true about Boxer's fracture management?

• A. Treated with a radial gutter splint.
• B. The wrist should be placed in full extension.
• C. Fracture of the 5th metacarpal head is treated with an ulnar gutter splint; the wrist is placed in slight extension with the MCP joint flexed 70 to 90 degrees and the PIP joint flexed 5 to 10 degrees; typically 3 to 4 weeks of splinting.
• D. Surgical fixation is required in all cases.

Answer: (C)

In Boxer's fracture, stability of the fracture and alignment during healing guide management. Most cases of the fifth metacarpal neck fracture are treated nonoperatively with an ulnar gutter splint to immobilize the ring and small fingers, while allowing motion of the other fingers. Positioning the hand with the MCP joints flexed about 70 to 90 degrees helps counteract the pull of the flexor tendons and maintains the fractured segment in a reduced position. Placing the wrist in slight extension and keeping the PIP joint only minimally flexed (a few degrees) helps maintain overall alignment without excess tension on the fracture. A typical course is immobilization for about 3 to 4 weeks, followed by rehab as needed. Surgical fixation isn’t required for all cases and is reserved for significant displacement, angulation, or rotational deformity, or when nonoperative treatment fails. The other options are inconsistent with standard management: a radial gutter splint targets the wrong side of the hand, full wrist extension is not the typical immobilization posture, and saying surgery is needed in all cases is incorrect.

In Boxer's fracture, stability of the fracture and alignment during healing guide management. Most cases of the fifth metacarpal neck fracture are treated nonoperatively with an ulnar gutter splint to immobilize the ring and small fingers, while allowing motion of the other fingers. Positioning the hand with the MCP joints flexed about 70 to 90 degrees helps counteract the pull of the flexor tendons and maintains the fractured segment in a reduced position. Placing the wrist in slight extension and keeping the PIP joint only minimally flexed (a few degrees) helps maintain overall alignment without excess tension on the fracture. A typical course is immobilization for about 3 to 4 weeks, followed by rehab as needed.

Surgical fixation isn’t required for all cases and is reserved for significant displacement, angulation, or rotational deformity, or when nonoperative treatment fails. The other options are inconsistent with standard management: a radial gutter splint targets the wrong side of the hand, full wrist extension is not the typical immobilization posture, and saying surgery is needed in all cases is incorrect.