Different functional splinting and soft wrap/bandage treatment methods were described to overcome the patient discomfort and the majority of the studies reported satisfactory outcomes. Although satisfactory clinical results were reported with the application of the traditional UGS splint, it may lead to high patient discomfort due to the limitation of wrist and finger movements. Closed treatment of these fractures with immobilization can lead to complications, such as malunion, extension lag, stiffness and reduced grip strength. Fractures of the fifth metacarpal are the most common fractures in the hand, and most of them are treated conservatively via ulnar gutter splint (UGS). Hand fractures are the most common fractures of the body, and 18–44% of all fractures in the hand occur in the metacarpal bones. Type of study/level of evidence: Therapeutic, II. Patient comfort and compliance may be better with FMS due to less joint restriction, and these findings should be considered when deciding the treatment method. However, in the long term, both FMS and UGS methods yield similar radiological and clinical outcomes. In stable 5th metacarpal neck fractures, FMS is adequate to prevent loss of reduction and yields faster improvement in clinical scores with earlier gain of normal grip strength compared with UGS. However, at the end of the 6th month follow-up, both groups exhibited similar reduction, QuickDASH and grip strength values. When the expected grip strengths were calculated, the FMS group reached the expected strength values at the 2nd month follow-up, whereas the UGS group still exhibited significantly lower grip strength at the 2nd month follow-up( p = 0.008). In the FMS group, the improvement in QuickDASH scores between the 2nd and 6th month follow-up was significant ( p = 0.003) but not in the UGS group( p = 0.075). However, this better initial reduction in FMS group(16 ± 7) could not be maintained in the 1st month follow-up (21 ± 5) ( p = 0.009). After reduction, significant correction was achieved in both groups, but the average angulation was lower in the FMS group(16 ± 7) compared with the UGS group (21 ± 8)( p = 0.043). The average age was 28 years (SD ± 12, range 18–43) in the FMS group and 30 years (SD ± 14, range 18–58) in the UGS group. Twenty-two patients were treated with FMS, and 18 patients were treated with UGS. Resultsįorty patients returned for follow-up. Angulation, shortening and functional outcome ( QuickDASH scores and grip strengths) were evaluated at the 2nd and 6th months. In total, 58 patients were included in the study and were treated with FMS or UGS after fracture reduction in a consecutive order. MethodsĪ prospective comparative study was designed to assess the conservative treatment of isolated and closed stable fractures of the fifth metacarpal neck. The aim of this study was to compare the radiological and clinical outcomes of two conservative treatment methods, functional metacarpal splint(FMS) and ulnar gutter splint(UGS), for the treatment of fifth metacarpal neck fractures. These fractures are generally treated with conservative methods. Fifth metacarpal fractures are the most common fractures of the hand.
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