CONSERVATIVE OR OPERATIVE TREATMENT OF ME TACARPAL FRACTURES

A total of 146 patients with 150 closed metacarpal fractures were trea ted between 1980 and 19 8 1, and 109 patients with 113 metacarpal frac tures (75%) were followed up (follow up 7.3 years). After conservative treatment, the functional results were good to excellent in 92.7%, wh ile 5.8% had satisfactory and 1.5% poor functional results. After oper ative treatment 81.5% had good or excellent functional results, 14.8% satisfactory results and 3.7%, poor functional results. The radiologic al result did not correspond with the functional result. Angulation of the Ist - IVth metacarpal bones by up to 20-degrees of the Vth metaca rpal bone by up to 50-degrees, and even shortening by up to 8 mm had n o detrimental influence on the functional results. Axial rotational de viation of the Vth metacarpal bone by up to 15' was tolerated. Joint f ractures with a 1 mm step could also be treated by conservatively mean s.