![]() ![]() The study population is planned to be 21 patients in each group. In human anatomy, the metacarpal bones or metacarpus form the intermediate part of the skeletal hand located between the phalanges of the fingers and the carpal bones of the wrist, which forms the connection to the forearm. The overall satisfaction of the patients and the costs for both treatments will be documented as well. The investigators will measure return to driving, work and sport.Ĭomplications will be registered continuously for all patients. The finger ranges of motion and pain will be evaluated with every follow-up, DASH score, range of motion, pain and grip-strength will be measured after 12v and 1 year. metacarpus The region of the hand between the wrist and the phalanges, which includes the five metacarpal bones that support the palm/hand. OBJECTIVE Hand fractures are common in childhood, and radiography is the standard diagnostic. Radiographs will be performed at 1v and 6v. Medline Abstract for Reference 8 of Metacarpal neck fractures. Diagnosis is made by orthogonal radiographs the hand. The participant will be seen for a follow-up at 1, 6 and 12 weeks and 1 year. Metacarpal Fractures are the most common hand injury and are divided into fractures of the head, neck, or shaft. A physiotherapist controls that early mobilisation is carried out. Furthermore the participants in the conservative group are allowed to use their hands without any restrictions. By this procedure shortening oft he metacarpalfractures is limited by the function of the deep transverse metacarpal ligament connecting the distal parts of the metacarpalbones II-V. The conservative group is instructed to do a fist to correct any malrotation and to rehabilitate quickly. The operative group is treated with internal fixation and 2 weeks in a cast. The thumb metacarpal can bend and extend the thumb, move the thumb away from and toward the hand, and spin. ![]() The patients are divided into two groups (operative and conservative treatment with early mobilisation). The thumb CMC joint has the most freedom of motion. The study is designed as an prospective, randomised controlled trial. Procedure: Early mobilisation Procedure: Operation The study is designed to answer the question if early mobilization is not inferior to operative treatment but with lower costs and without any operation related risks. An advantage of early mobilization is that the patient avoids the risk of an operation and the costs for the treatment are decreased markedly. In those cases the fractures may heal with some shortening but very good function. Symptoms Causes Diagnosis Treatment A fractured (broken) metacarpal is a common injury of the hand. New studies have shown that even displaced fractures can be treated with early mobilization. Even if this is an standard procedure both mild and severe complications have been reported. This usually includes an open reduction of the fracture and fixation with plates and screws or just screws. A functional analysis of short arm cast vs volar splint immobilization in the treatment of small finger metacarpal neck fractures abstract. ![]() With appreciable displacement especially any malrotation the patient usually is treated with an operation. With minimal displacement this fracture is usually treated with immobilisation or early mobilisation. Spiral metacarpal fractures (metacarpal II-V) can be treated conservatively or with operation. Why Should I Register and Submit Results?. ![]() This results in bone misalignment and improper finger rotation.Ĭhronic Regional Pain Syndrome (CRPS) is a soft tissue reaction leading to prolonged pain and other vascular neural changes of the injured hand but it is a rare complication. ComplicationsĬomplications after a metacarpal fracture include the non-union of the metacarpal bone when a fracture is neglected, when surgery is delayed, or in case of very unstable fractures. A closed reduction with percutaneous pining using K-wires is also a frequent option. Open reduction and internal fixation (ORIF) is performed in displaced fractures by performing a dorsal incision and placement of screws, plates and K-wires.Įxternal fixation is used in unstable fractures. Different methods are available for metacarpal fracture fixation depending on the fracture characteristics: The index metacarpal more often does need surgical treatment, as minimal anatomical changes in the finger alignment can alter the function of the entire hand. Are categorized as being fractures of the head, neck, shaft, and base. When conservative treatment fails to achieve bone alignment and healing surgery is necessary. Is a break in one of the five metacarpal bones of either hand. Surgery is required in significantly displaced metacarpal fractures, open fractures, complex intra-articular fractures, and fractures with an angulation over 30 degrees. ![]()
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