An alternative method of treatment for metacarpal fractures in athletes.

Abstract

To determine whether closed metacarpal fractures (MCFs) without evidence of shortening, displacement, rotational deformity, or unacceptable angulation could be successfully treated with a modified functional casting technique (glove cast). Retrospective chart review with a follow-up telephone survey to determine long-term outcome. Outpatient sport medicine clinic. 24 patients (22 male, 2 female, average age 15 +/- 1.7 years) with 25 MCFs resulting from sports participation. The casting technique consisted of either a fiberglass cast (22 patients) or orthoplast splint (2 patients), allowing full range of motion of the wrist. Patients were allowed to return to modified activity after initial evaluation and immobilization and full athletic activity upon radiographic demonstration of circumferential callus at the fracture site. Fracture healing, return to participation, complications, reinjury rates, residual symptoms, functional status, and patient satisfaction. Duration of immobilization was 4-5 weeks. All patients demonstrated radiographic evidence of union of the fracture site. All patients had returned to limited sports participation by 2 weeks and full participation by 4 weeks, with no complications, and no reinjuries occurred during the treatment period. Long-term follow-up at an average of 17.2 months showed no functional restrictions and good overall patient satisfaction. This method of immobilization demonstrates an acceptable alternative for specific, stable MCFs in athletes. Advantages include maintenance of wrist and forearm function during the period of immobilization, protection from reinjury, maximization of sports participation, and a high patient satisfaction rate.