Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Hand/Wrist
Abstract number: 26406
A RETROSPECTIVE STUDY OF THE POSITION OF IMMOBILISATION AND
FUNCTIONAL OUTCOME OF METACARPAL/PHALANGEAL FRACTURES
Prabhu ARUMUGAM 1 , Henry COLACO 1 , Shelain PATEL 2 , Arif KHAN 1
1 Whipps Cross University Hospital, London (UNITED KINGDOM), 2 University College
Hospital, London (UNITED KINGDOM)
AIMSRetrospective study of the immobilisation and functional outcome of
metacarpal/phalangeal fractures presenting, with subgroup of 5th metacarpal neck
fractures.FINDINGS53 patients presented with metacarpal/phalangeal fractures were
followed up at 4 months (3-5 months): 41 male, 12 female, 33 years (8.75-
87.39).Radiographs were assessed for angulation and displacement. Outcome was
assessed by patient satisfaction with treatment and outcome, and the functional
QuickDash score.RESULTSAmongst patients with QuickDash score >0, a higher
score correlated with a lesser degree of satisfaction with overall treatment and
outcome. Overall, there was no significant correlation between QuickDash score and
severity of fracture or operative/non-operative intervention. Of the 18 patients with
radiographs in a splint, 0 were in the safe position. In the subgroup of 15 patients
with 5th metacarpal neck fractures, 7 managed with neighbour strapping (A) and 8
with a plaster splint (B). There was no attempt at reduction and all splints were
removed at the first follow-up appointment. There was no significant difference
between the groups in terms of angulation or return to work. In group A, mean
QuickDash score was 2.56 and 100% were satisfied with treatment/outcome. In
group B, mean QuickDash score was 12.79 and 25% of patients (2) were unsatisfied
with treatment/outcome.CONCLUSIONS This pilot study does not support the use of
splint immobilisation for 5th metacarpal neck fractures.A prospective randomized
controlled trial is indicated.A larger study of the position of hand immobilisation in
plaster is indicated.
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