Boxer's fracture is often treated with which splint?

• A. Thumb spica splint
• B. Ulnar gutter splint
• C. Short arm cast
• D. Long arm cast

Answer: (B)

Immobilization that protects the metacarpal neck fracture of the fourth and fifth digits while preserving wrist motion is the goal. An ulnar gutter splint achieves this by spanning the forearm along the ulnar side and immobilizing the ring and little fingers at their MCP joints, effectively stabilizing the 4th and 5th metacarpals. This prevents angulation and allows the fracture to heal with minimal stiffness when nonoperative management is appropriate.

The other splints don’t address the injured area. A thumb spica splint primarily immobilizes the thumb, not the 4th and 5th digits. A short arm cast immobilizes the wrist and forearm, which is more restrictive than needed for a metacarpal neck fracture and can complicate recovery. A long arm cast is even more restrictive and unnecessary for this isolated injury.