[Outcomes of four distinct fixation methods in the conservative treatment of fifth metacarpal neck fractures].

BACKGROUND We evaluated four distinct fixation methods for the conservative treatment of neck fractures of the fifth metacarpal. METHODS Patients in our clinics who were treated with non-surgical methods following closed reduction between 2008 and 2009 were evaluated prospectively. In this study consisting of 60 male patients, the following fixation methods were applied for four weeks: circular cast extending from the wrist to the distal interphalangeal (DIP) joint (Group A), circular cast covering semiflexed metacarpophalangeal (MCP) and DIP from the wrist to the DIP joint (Group B), circular self-adherent wrap covering metacarpal bones II-V, from the wrist to the DIP joint (Group C), and ulnar gutter splint covering semi-flexed IV-V MCP, proximal (PIP) and DIP joints (Group D). In patients who were followed up with anteroposterior (AP) and oblique radiography, angulations and metacarpal lengths were measured before and after reduction. RESULTS Fifty-two patients with an average age of 30 (SD: 9) years completed the study. For fractures with radiographic angulation of 17 degrees (SD: 11) and 46 degrees (SD: 11.7) before treatment, union was achieved with an angulation of 5 degrees (SD: 5.9) and 27 degrees (SD: 10.5) after four weeks (p: 0.05). CONCLUSION No statistically significant difference was found between the non-surgical methods applied for treatment of fifth metacarpal fractures.

[1]  M. Uzun,et al.  Effects of fusion angle on functional results following non-operative treatment for fracture of the neck of the fifth metacarpal. , 2008, Injury.

[2]  A. Heins,et al.  Management of Emergency Department Patients With Boxer's Fractures: Functional Treatment or Immobilization? , 2008 .

[3]  A. Shin,et al.  Comparison of 2 methods of immobilization of fifth metacarpal neck fractures: a prospective randomized study. , 2008, The Journal of hand surgery.

[4]  D. Dennison Three Cast Techniques for the Treatment of Extra-articular Metacarpal Fractures: Comparison of Short-term Outcomes and Final Fracture Alignments , 2006 .

[5]  R. Poolman,et al.  Conservative treatment for closed fifth (small finger) metacarpal neck fractures. , 2001, The Cochrane database of systematic reviews.

[6]  R. Poolman,et al.  Immediate mobilization gives good results in boxer's fractures with volar angulation up to 70 degrees: a prospective randomized trial comparing immediate mobilization with cast immobilization , 2003, Archives of Orthopaedic and Trauma Surgery.

[7]  M. Uğurlu,et al.  [Evaluation of functional results in conservatively treated boxer's fractures]. , 2002, Acta orthopaedica et traumatologica turcica.

[8]  R. Beckenbaugh,et al.  Traction reduction and cast immobilization for the treatment of boxer's fractures. , 1999, Techniques in Hand & Upper Extremity Surgery.

[9]  H. Kuokkanen,et al.  Treatment of subcapital fractures of the fifth metacarpal bone: a prospective randomised comparison between functional treatment and reposition and splinting. , 1999, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[10]  D. Mass,et al.  The biomechanical effects of angulated boxer's fractures. , 1999, The Journal of hand surgery.

[11]  M. Braakman,et al.  Functional taping of fractures of the 5th metacarpal results in a quicker recovery. , 1998, Injury.

[12]  D. Greenwald,et al.  Metacarpal Fracture Angulation Decreases Flexor Mechanical Efficiency in Human Hands , 1977, Plastic and reconstructive surgery.

[13]  J. Lemmens,et al.  Conservative treatment of boxer's fracture: a retrospective analysis. , 1991, Injury.

[14]  P. T. Nielsen,et al.  Functional treatment of metacarpal fractures 100 randomized cases with or without fixation. , 1990, Acta orthopaedica Scandinavica.

[15]  R. L. Linscheid,et al.  Reliability of carpal angle determinations. , 1989, The Journal of hand surgery.

[16]  I. Lowdon Fractures of the metacarpal neck of the little finger. , 1986, Injury.

[17]  J. M. Hunter,et al.  Fifth metacarpal fractures in a compensation clinic population. A report on one hundred and thirty-three cases. , 1970, The Journal of bone and joint surgery. American volume.

[18]  S. A. Jahss FRACTURES OF THE METACARPALS , 1938 .