AN ALTERNATIVE METHOD OF TREATMENT FOR METACARPAL FRACTURES IN ATHLETES

Objective: To determine whether closed metacarpal fractures (MCFs) wit hout evidence of shortening, displacement, rotational deformity, or un acceptable angulation could be successfully treated with a modified fu nctional casting technique (glove cast). Design: Retrospective chart r eview with a follow-up telephone survey to determine long-term outcome . Patients: 24 patients (22 male, 2 female, average age 15 +/- 1.7 yea rs) with 25 MCFs resulting from sports participation. Intervention: Th e 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 actividy after initial evaluation and immobilization and full athletic activity upon radiographic demonstration of circumferential callus at the fracture s ite. Main outcome measures: Fracture healing, return to participation, complications, reinjury rates, residual symptoms, functional status, and patient satisfaction. Results: 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 participat ion by 2 weeks and full participation by 4 weeks, with no complication s, and no reinjuries occurred during the treatment period. Long-term f ollow-up at an average of 17.2 months showed no functional restriction s and good overall patient satisfaction. Conclusions: This method of i mmobilization demonstrates an acceptable alternative for specific, sta ble MCFs in athletes. Advantages include maintenance of wrist and fore arm function during the period of immobilization, protection from rein jury, maximization of sports participation, and a high patient satisfa ction rate,