Abstract
Introduction
Surgical treatment is justified in patients with fifth metacarpal shaft fractures with angulation exceeding 30 degrees, as these patients are prone to have shortening, restriction of movements, decreased efficiency of the flexor tendons and poor cosmetic results1,2. The authors describe a new technique where these patients can be treated in the clinic non-surgically.
Material and Methods
Twenty-three patients with angulated fractures were prospectively enrolled for the study from Jan 2009 to Dec 2009. After appropriately instructing the patient, an ulnar nerve block was performed at the wrist. Once the nerve block had taken effect, the fracture was manipulated and an ulna gutter 3-point moulded splint was applied in the plaster room. The reduction was then confirmed with an x-ray. The patients were seen at 3 weeks for splint removal and for long-term follow-up at least 6 months later.
Results
All the patients had a completely pain-free manipulation and complete reduction was achieved in all the patients. There were no complications related to the technique.
Conclusions
In the NHS with pressure on resources, the authors suggest the treatment described above of these fractures in the clinic. It is a safe, cost-effective and easily learnt technique.
