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Minor fracture study packs a big punch for patients

Dr Richard Pellatt demonstrates the new buddy taping compared to the traditional plaster cast.

A Gold Coast Health led study into the treatment of a common hand injury is set to make a significant impact to fracture patient recovery times while also helping to ease Emergency Department demand.

Research lead Dr Richard Pellatt said the randomised, controlled trial of 126 patients who presented with a ‘boxer’s fracture’ compared the outcomes from the routine practice of plastering these injuries, with a more ‘user friendly’ approach.

“We see up to ten patients presenting with a fifth metacarpal fracture of neck of the hand per week, many of which are working age men in their mid-20’s,” Dr Pellatt said.

“Having an immobilised hand in plaster cast results in a significant amount of time off work and subsequent loss of income, and sport and social activities for these patients.

“When we buddy taped, we found the patients generally spent 30 minutes less in the ED than plaster patients and went back to work within seven days of presenting, with some resuming normal activities straight away.”

Dr Pellatt said boxer’s fracture patients were a notoriously difficult group to follow up post-ED treatment, with very few attending their outpatient clinic appointment.

“Buddy tape patients could be followed up over the phone or with their GP, rather than attending the fracture clinic for orthopaedic specialist review,” he said.

“This in turn frees up appointments for patients with more acute orthopaedic needs and frees up some time for orthopaedic specialists and plaster technicians.”

Emergency physician Gerben Keijzers said when the study commenced three years ago it was the only Australian trial of its kind on a local population.

“A $17,000 grant from the Emergency Medicine Foundation was a big boost for the trial and allowed us to hire a full-time research nurse to follow patients and put some money towards the statistical analysis from our Griffith University colleagues,” Mr Keijzers said.

Director of Emergency Services Dr David Green said while the trial was a small study on a minor injury, it punched above its weight in outcomes for patients and the health service.

“There’s no question minor injuries take up significant resources in our EDs, and I commend our staff for thinking outside the square to help manage that demand,” Dr Green said.

“It’s small innovations like this that can make a big difference to patient outcomes and patient flow in our EDs, and I look forward to seeing buddy taping become standard practice.”

Emergency Medicine Foundation Chair, Dr Kim Hansen said the buddy taping research had led to a rapid change in clinical practice, which was benefiting both patients and the emergency healthcare system.

“Dr Richard Pellatt’s buddy taping research is an example of the quality research funded by the Emergency Medicine Foundation, which is reducing the ever-increasing demands on our emergency departments,” said Dr Hansen.

The Emergency Medicine Foundation’s Queensland Research Program is funded by Queensland Health.

Last updated 27 Nov 2019