Comparing Short-term Function and Pain After No Treatment or Splinting for Boxer's Fracture

Study Overview
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Brief Summary
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This Study is being done because the investigators would like to know if pain and hand function after having a boxer's fracture differs between being treated with supportive splinting or without splinting, but with behavioral modifications.

Detailed Description
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After initial treatment in the emergency department, patients with boxer's features are referred to the division of plastic and reconstructive surgery at Sunnybrook hospital. During initial consultation with the hand surgeon, treatment is chosen. Patients are follow-up with their hand surgeon at 4-, 8-, and 12--week intervals. Supportive splinting: Patient's are given a removable plaster/fiberglass splint with a tensor bandage underneath. Behavioral Modifications: Patients are not splinted, but provided a tensor bandage. Patients are instructed on specific behaviours to prevent movement of the injured part of the hand. The purpose of the study is to compare pain and short-term hand function in patients who undergo supportive splinting compared to patients who undergo behavioral modifications treatment only to see which option is associated with shorter functional recovery and which option is associated with less pain during the first 4 weeks after initial treatment. On follow-up appointments at 4, 8,and 12 weeks, as well as initial consultation with the hand surgeon, participants will be asked to perform a grip strength test with a Jamal Hydraulic hand Dynanometer. Participants will be asked to fill out a Brief Michigan Hand Questionnaire along with the grip strength test as well as quick demographics survey at initial consultation with the hand surgeon. After the 12-week follow up appointment, study participation will end. If a patient is unable to follow-up with the hand surgeon, the Brief Michigan Hand Questionnaire will be done via phone whenever is most convenient for the patient. It's anticipated that about 40 people will participate in this study at a single centre in Toronto.

Official Title
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Comparing Short-term Function and Pain After No Treatment or Splinting for Boxer's Fracture

Conditions
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Metacarpal Fractures

Intervention / Treatment
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* Behavioral: Behavioral Modification
* Behavioral: Splint


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of true boxer's fracture Candidate for either supportive splinting or tensor bandage Speaking, read and write English Exclusion Criteria: Prior surgical treatment for boxer's fractures or other hand conditions. Concurrent hand/wrist injury

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Splint<br>Patients will be provided instructed to use a tensor bandage as well as specific behaviours to prevent movement of the injured part of the hand. | Behavioral: Splint<br>* fibreglass splint<br>|
| Experimental: Behavioral Modification<br>Patients are given a removable plaster/fiberglass splint with a tensor bandage underneath | Behavioral: Behavioral Modification<br>* Patient will be provided with tensor bandage and instructed on specific behaviors to prevent movement of the injured part of the hand.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hand function | measured by Brief Michigan Hand Questionnaire (MHQ) | 4 weeks | 
| hand function | measured by Brief Michigan Hand Questionnaire (MHQ) | 8 weeks | 
| hand function | measured by Brief Michigan Hand Questionnaire (MHQ) | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Grip strength | measured using Dynamometer | 4 weeks | 
| Grip strength | measured using Dynamometer | 8 weeks | 
| Grip strength | measured using Dynamometer | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Fracture, Follow-up, metacarpal