The orthopedist making the intervention at the E.R. The treatment plan was applied to patients in a consecutive manner based on referral time (quasi-randomisation). The power analysis, based on previous reports, revealed that at least 14 subjects were needed in both groups for a power of 0.8 at a significance level of 0.05. Patients were recruited from the University Hospital Emergency Room (E.R.) and were treated with FMS or UGS. We hypothesized that in the treatment of stable metacarpal neck fractures, FMS is adequate to prevent loss of reduction and results in a faster recovery compared with UGS.īetween 20, a prospective comparative study was designed for the treatment of 5th metacarpal neck fractures. The aim of this study is to compare UGS and FMS in the treatment of fifth metacarpal neck fractures regarding the functional and radiological results to understand whether UGS represents an overtreatment of fifth metacarpal neck fractures that are suitable for conservative management. However, the evidence for its superiority in terms of reduction maintenance and functional outcome is still lacking. Acceptable outcomes have also been reported after the treatment of distal and diaphyseal fractures of the fifth metacarpals with a well-molded functional metacarpal splint (FMS), which is less restricting and more comfortable compared with UGS. 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. 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.
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