Early Range of Motion in 5th Metacarpal Fracture

Launched by MCMASTER UNIVERSITY · May 7, 2015

Keywords

ClinConnect Summary

Fractures of the fifth metacarpal neck ("boxer's fractures"), are the most common injury to the upper extremity. They are the result of axial force on a flexed metacarpalphalangeal (MCP) joint. Typically, they are caused by striking a hard object with a closed fist, breaking the knuckle on the "little" finger. Restoring hand function quickly and reliably for return to work and/or activity is of utmost importance. These patients are a significant labour force demographic. Since the injury is not characteristically sustained at work, "return-to-work"is an important patient consideration for l...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Age equal or greater than 18 years
• • 2. Fifth metacarpal neck fracture, 9 or fewer days since injury
• • 3. Equal or less than 40 degrees of dorsal fracture angulation on lateral x-ray. Angle is measured between the line along the longitudinal axis of the metacarpal shaft and the line from the centre of the metacarpal head to the fracture site.
• • 4. No angulation or malrotation
• • 5. No clinical fracture shortening (ie. Inability to extend fifth digit)
• • 6. Non-operative treatment
• • 7. Volar or ulnar gutter splint (MCP flexed, IPs extended)
• Exclusion Criteria:
• • 1. Metabolic bone disease
• • 2. "Open fracture" with soft tissue loss overlying fracture site
• • 3. Tendon injury
• • 4. Neurovascular injury
• • 5. Clinical rotatory malalignment
• • 6. Fracture shortening demonstrated by "pseudoclawing"
• • 7. Other fracture in the ipsilateral upper extremity
• • 8. Any operative indication
• • 9. Previous fracture to the involved fifth ray