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This evidence-based review evaluates immobilization versus functional treatment of fifth metacarpal fractures. A systematic search of MEDLINE, Google Scholar, and The Cochrane Library was performed. The evidence of five papers, four randomized controlled trials and one systematic review, was evaluated to produce a clinical recommendation. Each paper compared immobilization and functional treatment and found no differences in outcomes. Unfortunately, the methodology of the randomized trial was weak, limiting the strength of the recommendation. On the basis of the review of the evidence it is recommended that the advanced emergency nurse use functional treatment for treatment of fifth metacarpal fractures.
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