A safe and cost-effective method for treatment of angulated fifth metacarpal shaft fractures in the out-patient clinic

Karthik Karuppaiah, Sunit Patil, Sanjay Miranda

    Research output: Contribution to journalArticlepeer-review


    Surgical treatment is justified in patients with fifth metacarpal shaft fractures with angulation exceeding 30°, as these patients are prone to have shortening, restriction of movements, decreased efficiency of the flexor tendons and poor cosmetic results. 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 assessed using disability of arm, shoulder and hand (DASH) score and radiographs at follow-up.
    At the average follow-up of 12.38 months (range, 9–17), the DASH score was 2.03 (range, 0–6.7). The return to sports/work was at 3.2 weeks (range, 1–6) following the injury. The DASH work and sports score was 3.55 (range, 0–12.5) and 0.89 (range, 0–12.5) respectively. The mean initial fracture angulation of 40.05°, reduced to 15.76°. All the patients had a completely pain-free manipulation with no complications related to the technique and reduction.
    In the current economic climate with pressure on time and resources, the authors suggest the treatment described above of these fractures in the clinic. It is a safe, cost-effective and easily learnt technique.
    Original languageEnglish
    Pages (from-to)31-35
    Number of pages5
    JournalEuropean Journal Of Orthopaedic Surgery And Traumatology
    Issue number1
    Publication statusPublished - Mar 2014


    • Fifth metacarpal shaft fractures
    • Hand fractures
    • Cost-effective
    • Conservative treatment
    • Ulnar nerve block


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