BOXER CAST

 

Boxer Cast

INDICATIONS:

Fx 5th Metacarpal (Boxer Fx)

Metacarpal Fractures

Some Phalangeal Fractures

CLASSIC BOXER FRACTURE

(Distal 5th Metacarpal)

Boxer Fracture distal 5th metcarpal

MATERIALS:

1” Stockinette for thumb

1”  Stockinette for ring finger

2” Stockinette for arm

2   2” rolls of webril

2   2” rolls of fiberglass

Scissors

Casting gloves

APPLICATION:

Cast may be gauntlet or short arm length depending upon surgeon’s preference.


Place thumb stockinette and other 1” stockinette over ring finger. Cut 2 slits in arm stockinette. First slit will be apprx 4 inches from top of stockinette, second slit will be apprx 3 inches below first slit.  Roll up arm stockinette and place over hand. First slit you will place index and long finger through, second slit will be for the thumb.  Next roll webril starting at wrist, two pass throughs the thenar space, direct webril upward starting to cover the the 4th and 5th metacarpal heads, continue around the ring and little fingers. Place 2 or 3 layers of webril around the 4th/5th fingers, come back down and cover 4th and 5th knuckles again (looking like a criss/cross or basketweave) continue webril down the arm as you would with a short arm cast.


Fiberglass:  Follow same pattern as the webril. Start with 2 to 3 base wraps around the wrist. Direct fiberglass thru thenar space twice using either cutting or twisting technique. After second pass thru the thenar space, guide fiberglass around back of hand and cover the 4th and 5th metacarpal heads, continue directing the fiberglass upward and wrap around the 4th and 5 fingers. Be sure to bring fiberglass out to the tip of the fingers. Direct fiberglass back down the fingers and again over the 4th/5th metacarpal heads creating a criss/cross. You will do this same pattern with your second roll of fiberglass so you will have 2 criss/cross patterns to lock in the finger spica to the hand portion of the cast.

MOLDING:

Boxer casts must have a 3 point fixation mold in order to hold the fractured metacarpal head in place. The position of the mold does depend on the anatomical fracture position of the metacarpal. The following is a general description of a 3 point mold...

with your thumb place on the palmar side at the metacarpal head molding inward. At same time use your index and long finger and place on dorsal side of the hand below the knuckle and mold.  Patient’s wrist should be placed in as much flexion as possible. With your free hand, place flat of your palm on top of patient’s casted 4th and 5th fingers and apply pressure to bring MP joints to 90 degrees while keeping the fingers straight.

Click on left arrow to play Boxer cast application video