INITIAL TREATMENT OF CLOSED METACARPAL FRACTURES - A CONTROLLED COMPARISON OF COMPRESSION GLOVE AND SPLINTAGE

A prospective clinical trial compared two forms of initial management for closed stable fractures of the shaft of the finger metacarpals. Pa tients were randomized to treatment with a compression grove and early mobilization (21 patients) or to immobilization in a plaster splint ( 21 patients). The mean loss of total active flexion (MP+PIP+DIP) in th e second week after injury was 56 degrees in the glove group and 84 de grees in the splint group (P=0.0036). In the third week, the mean loss of flexion was 23 degrees and 46 degrees respectively (P=0.0010). Han d volume and PIP joint circumference were significantly smaller in the glove group in the second week but not in the third and fourth weeks. Within each group, however, there was no correlation between range of motion and swelling, suggesting that these were independent variables in this study. The support of the glove helped to relieve pain. Use o f a compression glove avoided the loss of function imposed by splintag e and was associated with a greater range of movement during the secon d and third weeks.